ESTRO 2023 - Abstract Book


Saturday 13 May

ESTRO 2023

Conclusion We believe these recommendations will standardise the RT treatment of vulvar cancer in the UK. We also aim to improve compliance with national recommendations such as the treatment of vulvar cancer as category 1 and compensation of gaps during treatment. The national RCR audit will be repeated in 2024 to assess the impact of these recommendations on UK practice. References 1. Baird P DK, Forrest J, Stewart A “The Royal College of Radiologists National Vulvar Cancer Audit”. 2022. 2. Gaffney DK, King B, Viswanathan AN, Barkati M, Beriwal S, Eifel P, et al. Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma. Int J Radiat Oncol Biol Phys. 2016;95(4):1191-200.DOI: 10.1016/j.ijrobp.2016.02.043. MO-0054 Quality of life results of the APROVE trial after proton beam therapy for gynecological cancer E. Meixner 1 , A. Wark 1 , T. Forster 1 , F. Weykamp 2 , K. Lang 1 , L. König 1 , K. Lindel 3 , J.T. Oelmann-Avendano 4 , J. Krisam 5 , A. Schneeweiss 6 , M. Ellerbrock 7 , T. Mielke 7 , J. Hörner-Rieber 1 , K. Herfarth 1 , J. Debus 1 , N. Arians 1 1 Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany; 2 Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg , Germany; 3 Municipal Hospital Karlsruhe, Department of Radiation Oncology, Karlsruhe, Germany; 4 Göttingen University Hospital, Department of Radiation Oncology, Göttingen, Germany; 5 University of Heidelberg, Institute for Medical Biometry and Informatics, Heidelberg, Germany; 6 Heidelberg University Hospital, Department of Gynecology and Obstetrics, Heidelberg, Germany; 7 Heidelberg Ion Therapy Center (HIT), Heidelberg Ion Therapy Center (HIT), Heidelberg, Germany Purpose or Objective Trial registration: The trial was registered at ( Identifier: NCT03184350, 9th June 2017). The prospective APROVE-trial investigated the tolerability of postoperative proton beam therapy in women with cervical or endometrial cancer. The present analysis evaluated the secondary endpoints of health-related quality of life (HRQOL) and patient-reported symptoms. Materials and Methods 25 patients were included in this prospective phase-II-trial and treated with postoperative radiotherapy using protons alone or in combination with chemotherapy. To attain general and gynecologic-specific HRQOL measures, the EORTC-QLQ-C30 questionnaires combined with -QLQ-CX24 for cervical and -QLQ-EN24 for endometrial cancer were assessed at baseline, at the end of RT and up to 2 years after radiotherapy. The results were compared to an age-matched norm reference population. Symptoms were assessed using Common Terminology Criteria for Adverse Events. Results Scores regarding global health status were markedly impaired at baseline (mean: 58.0±20.1) compared to reference data (Figure 1), but significantly (p=0.036) improved and evened out to comparable norm values two years after proton therapy (mean: 69.9±19.3). Treatment caused acute and long-term worsening of pain (p=0.048) and gastrointestinal symptoms (p=0.016) for women with endometrial cancer, but no higher-grade ≥ 3° toxicity was observed. Dosimetric evaluation of rectum, sigmoid, large and small bowel showed no correlation with the reported gastrointestinal symptoms. After 2 years, fatigue had significantly improved (p=0.030), whereas patients with cervical cancer experienced more often lymphedema (p=0.017). Scores for endometrial cancer pertaining to sexual activity (p=0.048) and body image (p=0.022) had improved post treatment; in the latter this effect persisted after 2 years (Figure 2).

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