ESTRO 2024 - Abstract Book

S1037

Clinical - Gynaecology

ESTRO 2024

1383

Digital Poster

THE ROLE OF ADJUVANT RADIOTHERAPY IN PATIENTS WITH VULVAR CANCER: A MONOCENTRIC EXPERIENCE

VALENTINA LANCELLOTTA 1 , Gabriella Macchia 2 , Donato Pezzulla 2 , Bruno Fionda 1 , Martina De Angeli 1 , Giorgia Garganese 3 , Simona Maria Fragomeni 3 , Gabriella Ferrandina 3 , Benedetta Gui 4 , Miriam Dolciami 4 , Maria Antonietta Gambacorta 1 , Luca Tagliaferri 1 1 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Radioterapia Oncologica, ROMA, Italy. 2 Università Cattolica del Sacro Cuore, Radioterapia Oncologica, Campobasso, Italy. 3 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento Scienze della salute della donna, del bambino e di sanità pubblica, ROMA, Italy. 4 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, ROMA, Italy

Purpose/Objective:

To confirm the efficacy and safety of adjuvant radiotherapy (aRT) in patients with vulvar cancer who underwent modern image-guided radiotherapy aRT.

Material/Methods:

We conducted a retrospective analysis of 91 patients diagnosed with primary vulvar cancer who underwent post operative radiation therapy with curative intent from August 2012 to May 2023. The primary study endpoint was the local control (LC), secondary end-points were the distant metastasis free survival (DMFS), progression free survival (PFS), overall survival (OS), and the rate and severity of acute and late toxicities.

Results:

All patients received planned treatment. 37 patients were stage IB, 3 patients’ stage II, 50 patients’ stage III (31 IIIA, 13 IIIB, 6 IIIC) and one stage IVA (International Federation of Gynaecology and Obstetrics stages 2008). More patients’ details are shown in Table 1. The median total dose of external beam RT ranged between 45Gy-66Gy. Concurrent chemotherapy was administered in 41 patients. The median duration of follow-up was 29 months (1 109 months), while the median overall treatment time (OTT) was 37 days (30-235 days). Two-year LC, DMFS, PFS and OS rates were 82.3%, 91.8%, 78.4%, 85.9%, respectively (Figure 1); Patients with an OTT < 53 days showed a statistically significant higher LC, DMFS, and PFS (log rank test, p<0.05), but no difference was found in terms of OS (log rank test, p: 0.922). For LC, only OTT< 53 days (p: 0.007) and chemo-RT (p: 0.048) resulted as statistically significant positive prognostic factor at the Cox univariate analysis, but only OTT was then confirmed at the multivariate analysis (p: 0.001). Acute toxicity was registered in 29 patients: 29 cutaneous ones (3 G1 cases, 22 G2 cases, and 4 G3 cases), and 6 gastro-intestinal ones (all G2 cases). Regarding late toxicities, only 5 cases were registered: 3 cases of cutaneous toxicity (all G2), and two cases of lymphoedema (1 G1 and 1 G2).

Conclusion: