ESTRO 2024 - Abstract Book

S1041

Clinical - Gynaecology

ESTRO 2024

2009 stages were IA (60%), IB (24%) and II (16%). Adjuvant treatment consisted of CT alone (CT group, n=6, 12%), WPRT or VBT alone (RT group, n=6, 12%) or CT+RT (chemotherapy and VBT or WPRT +/- VBT boost, n=36, 72%). Most patients in the CT+RT group received sequential radiotherapy in the form of VBT alone (n=19, 53%). Two patients did not undergo any type of adjuvant therapy and were excluded from the subsequent analysis. Median follow-up was 90.9 months (28.3 months in the CT group, 141.9 months in the RT group and 97.6 months in the CRT group). At the time of the analysis, 17 patients have died. OS and DFS at 3 years respectively were: 81% and 78% for the whole cohort, 33% and 50% for the CT group, 67% and 80% for the RT group, and 91% and 83% for the CRT group. Patients receiving CRT had significantly better OS (HR 0.14, CI 95% 0.04-0.52, p<0.005) and DFS (HR 0.25, CI 95% 0.07-0.97, p=0.05) than patients treated with CT alone. There were no significant differences in OS or DFS between patients treated with RT and those receiving CRT or CT alone. Recurrence was seen in n=14 (29%), of which 11 patients (71%) have died. Most common pattern of recurrence was distant failure (n=8 patients) with similar rates between the CT and CRT groups (17% and 19% respectively). Next most common was combined simultaneous loco-regional and distant failure, present in 4 patients, with the highest rate in the RT alone group (33%, 2 out of 6 patients). Loco-regional failure alone was seen only in 2 patients, both in the CT group (33%, 2 out of 6 patients). The most common acute G3+ toxicity was hematological (n=12, 25%), followed by gastro-intestinal (GI) (n=2, 4%) and genitourinary (GU) (n=1, 2%). Late G3+ toxicity was infrequent, with 2 patients (4%) presenting with hematological events and 1 patient (2%) with GU toxicity. No patients presented with late G3+ GI toxicity.

Conclusion:

Stage I-II SEC has a high recurrence rate despite the use of adjuvant therapies. Adjuvant CT+RT had better OS and DFS than CT alone and no significant differences compared to EBRT alone. Although limited by the study design, small sample size, and heterogeneity of interventions, our results are consistent with larger randomized trials showing similar survival outcomes between VBT and CT versus EBRT alone. Distant failure alone or in combination with loco-regional recurrence were the most frequent patterns of failure. This highlights the need of novel systemic agents for the management of SEC. Overall the most frequent severe acute toxicity was hematological. Despite this, severe late toxicity was rare even in the combined modality group.

Keywords: early serous endometrial cancer, adjuvant therapy

1841

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Clinical outcomes and patterns of recurrence in the treatment of locally advanced cervical cancer

Aoiffe C Magner 1,2 , Laura T Royo 2 , Bolanle Ofi 2

1 SLRON, Radiotherapy, Dublin, Ireland. 2 Cork University Hospital, Radiotherapy, Cork, Ireland

Purpose/Objective:

Locally advanced cervical cancer (LACC) is the 8th most common invasive cancer in Ireland, affecting younger women and accounting for 3.7% of overall cancer mortality 1 . The standard treatment approach involves concurrent chemoradiotherapy (CCRT) followed by brachytherapy (BT). This study retrospectively assesses the clinical outcomes of LACC patients treated with External Beam Radiotherapy (EBRT) and MRI-based Adaptive Brachytherapy (IGABT) over a 5-year period. We aim to evaluate clinical outcomes, overall survival, and recurrence