ESTRO 2024 - Abstract Book

S1106

Clinical - Gynaecology

ESTRO 2024

Rachida Laraichi 1,2 , Karima Nouni 1,2 , Chadia Ezzouitina 1,2 , Fatima zahra Chraa 1,2 , Sara Smiti 1,2 , Amine Lachgar 1,2 , Hanan El kacemi 1,2 , Tayeb Kebdani 1,2 , Khalid Hassouni 1,2 1 National Institute of Oncology, radiotherapy, Rabat, Morocco. 2 Mohamed V University, faculty of medecine and pharmacy, Rabat, Morocco

Purpose/Objective:

The standard treatment for locally advanced cervical cancer is radiotherapy combined with platinum-based chemotherapy. Radiotherapy is generally external beam radiotherapy delivered to the pelvis with or without para aortic lymph nodes followed by a brachytherapy boost. However, patients unable to continue brachytherapy have a higher risk of local recurrence. The aim of our study was to evaluate the impact, in terms of clinical outcomes and acute and late toxicity, of external radiotherapy boost with IMRT when used as an alternative treatment to brachytherapy, in selected patients undergoing definitive radiotherapy for locally advanced cervical carcinoma and who are unfit for brachytherapy.

Material/Methods:

We retrospectively analyzed the data of 28 patients unsuitable for brachytherapy treated for locally advanced cervical cancer, who received external beam radiotherapy with concomitant chemotherapy (weekly cisplatin).

The boost was delivered between January 2021 and December 2022 by IMRT technique. The Kaplan-Meier method was used to calculate 2-year overall survival, progression-free survival, and 2-year local control.

Overall survival and progression-free survival were calculated from the date of initiation of radiotherapy, while local control was calculated from the end of radiotherapy.

Results:

The average age of the patients was 51 years (40-81 years). The total dose of radiotherapy received initially was 46 Gy in 23 fractions (2Gy/fraction) administered to the cervix, uterus, parameters, ovaries, vagina (depending on vaginal extension). ), as well as affected lymph nodes and groups of lymph nodes draining the cervix. Para-aortic lymph nodes were included if involved. The boost was 20 to 24 gy and included all residual tumor identified on the evaluation MRI.

After a median follow-up of 22 months (range: 6–31 months), local relapse occurred in two women (7%), while progression with distant metastasis was recorded in three patients (10.7%). .

Two-year local control and overall survival rates for all stages were 74% and 69%, respectively. According to the Common Terminology Criteria for Adverse Events CTCAE v.5, 12 patients experienced grade 1-2 acute genitourinary and/or rectal toxicity. Late rectal toxicity requiring laser coagulation was recorded in four patients. No G3-4 toxicity was observed after IMRT boost administration.

Conclusion: