ESTRO 2023 - Abstract Book

S843

Tuesday 16 May 2023

ESTRO 2023

It was a mixed population of patients with or without nephrectomy and it was shown, that patients receiving immunotherapy alone can also obtain a good response to the primary tumor. However, overall these patients appear to have a worse outcome when no cytoreductive nephrectomy is performed. Since a nephrectomy is an invasive procedure and radiotherapy could co-stimulate the antitumor immune response, there are now prospective trials available evaluating the use of SBRT as cytoreductive option. These trials treated larger tumors with a moderate dose. The effect SBRT to the kidney function was not significant. In one trial, the kidney was removed directly afterwards. It showed that there was an increase of cytotoxic and regulatory T cells within the tumor. This could be interesting for the combination with immunotherapy. Therefore, the Cytoshrink trial has been proposed, a randomized trial comparing nivolumab/ipilimumab with SBRT to the primary to nivolumab/ipilimumab alone in intermediate/poor risk patients to enhance immunomodulatory effect. Metastases-directed stereotactic radiotherapy also plays an increasingly important role in RCC patients who are oligoprogressive under immunotherapy and SBRT has been added to the international guidelines as accepted treatment in this situation. This talk will further explore the efficacy and safety of SBRT in (oligo)metastatic patients receiving immunotherapy. SP-1037 Surgery (T1a, T1b1 - T1b3, FST, Cancer in pregnancy) D. Cibula 1 1 1st Medical Faculty, Charles University and General Faculty Hospital in Prague, Department of Obstetrics and Gynecology, Prague, Czech Republic Abstract Text First version of the clinical practice guidelines for patients with cervical cancer, developed in collaboration of three societies (ESGO, ESTRO, ESP) were published already in 2018. Last year, the international working group, composed of experts from several disciplines, including gynecological oncology, medical oncology, radiation oncology, pathology, radiology and palliative medicine, has been not only reviewing and updating the previous version, but also expanding it by adding chapters on palliative care and rare tumor types. The update guidelines, which will be presented at the symposia, reflect new developments in all fields of cervical cancer management within the last 5 years. They were launched only recently at the ESGO congress in November 2022. SP-1038 Locally advanced disease and adjuvant treatment U. Mahantshetty 1 1 Homi Bhabha Cancer Hospital & Research Centre (A Unit of TMC, Mumbai) , Radiation Oncology , Visakhapatnam , India Abstract Text ESGO-ESTRO-ESP guidelines on cervical cancer were published in 2018. These guidelines were recently reviewed for an update which were presented at ESGO Conference 2022 and will be available soon. This presentation will provide updates on management guidelines including, adjuvant treatment after initial surgery and locally advanced cervical cancer (T1b3 T4a or LN positive). The updates include management of cervical cancer diagnosed on a simple hysterectomy (SH) specimen, adjuvant therapy after radical surgery and state-of-the-art non -surgical treatment for locally advanced cervical cancers. Principles of radiotherapy including EBRT, BT, concomitant chemotherapy and dose prescription etc. will be discussed. Joint Symposium: ESTRO-ESGO-ESP: Guidelines on cervical cancer

SP-1039 Systemic treatment in advanced and metastatic disease R. Nout The Netherlands

Abstract not available

SP-1040 Pathology M.R. Raspollini 1 1 University Hospital Careggi, Florence, Histopathology and Molecular Diagnostics, Florence , Italy

Abstract Text The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) nominated an international multidisciplinary development group consisting of practicing clinicians who have demonstrated leadership and expertise in cervical cancer to produce evidence-based guidelines regarding all aspects of the management of patients with this disease. The first version was published in 2018. The new version is not only a reviewing and updating the previous version, but also expanding it by adding chapters on rare tumor types, ancillary studies (p16 immunohistochemistry, HPV testing, PD-L1 testing) and palliative care. Herein, we provide a detailed list of the pathological reporting of cervical carcinoma specimens, focusing on practical aspects of specimen sampling and on the core pathological data which are critical for patient management. • Specimens from prior conization and subsequent conization, trachelectomy, or hysterectomy should be correlated for estimation of the tumour . This is of importance because different specimens may have been reported at different institutions. It should also be recognized that simply adding the maximum tumour in separate specimens may significantly overestimate the maximum tumour dimension.Histological tumour type according to the most recent WHO classification (currently 5th edition, 2020, in its updated version). • The presence or absence of lymphatic vessel invasion (LVI), which may be confirmed by immunohistochemistry. The quantification of the number of lymph vascular vessels involved by tumour cells is not mandatory but advisable for future prospective studies.

• The presence or absence of venous invasion (V1) and of perineural invasion (Pn1). • Coexisting precursor lesions such as squamous intraepithelial lesion/ cervical intraepithelial neoplasia,