ESTRO 2024 - Abstract Book


Clinical - Gynaecology

ESTRO 2024

addition to EBRT (external beam radiotherapy) [3]. The importance of overall treatment time (OTT) on cervical cancer control and survival rates has been well documented. Loss of local control and overall survival, when treatment exceeds 52 days, is approximately 1% per day [4]. Time dose and fractionation schedules have been altered in an attempt to improve the probability of local control. Hypo-fractionated radiotherapy delivers a high dose per fraction (>2-2.5Gy), daily for 5 days with a gap of 24 hours. In hypo-fractionated treatment, the OTT is reduced. However, the chances of late complications increase with increasing doses per fractionation. The present study was carried out to assess the acute and late toxicities as well as survival outcomes in patients of locally advanced cervical cancer treated with hypo-fractionated radiotherapy with concurrent chemoradiation.


For this retrospective analysis, medical records of patients with locally advanced cervical cancer from January 2010 to December 2016 were reviewed. Patients with FIGO stage IB to IVA disease who had received hypo-fractionated radiotherapy (RT) with concurrent chemotherapy followed by brachytherapy boost were included. A critical inclusion criterion for the study was that all patients had a minimum of two years of follow-up data available. The information retrieved from these records included patient demographics, the stage of cervical cancer, treatment details encompassing the specifics of hypo-fractionated RT, concurrent chemotherapy and brachytherapy boost as well as acute and late treatment-related toxicities. The data was entered and analyzed using SPSS software version 20.0. Kaplan-Meier survival analysis was done to estimate overall survival (OS) and disease-free survival (DFS). Primary outcomes included OS, DFS, and acute toxicities, while secondary outcomes comprised an evaluation of late complications.


The patient, tumor, and treatment characteristics of the cohort of 94 patients subjected to hypofractionated chemoradiotherapy are depicted in the table. Acute toxicity during treatment and till 3 months of follow-up after RT completion were assessed. Grade 3 or higher acute toxicities (hematological, skin, gastrointestinal, or genito urinary) were observed in 19.1% (n=18) cases and were managed conservatively. None of the patients encountered treatment-related death. On long-term follow-up, only a low proportion of patients suffered severe late toxicities which were predominantly lower gastrointestinal reactions with grade 3 or higher toxicities seen in 3.2 % of cases (n=3).

Median Age

50 years (Range: 34-73)

Duration of Symptoms


<6 months ≥6 months

58 (61.7) 36 (28.3)

Menstrual History


Pre-menopausal Post-menopausal

18 (19.1) 76 (80.9)




51 (54.3)


35 (37.2) 8 (8.5)

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