ESTRO 2024 - Abstract Book

S258

Brachytherapy - Gynaecology

ESTRO 2024

Compared to the overall EMBRACE-I results [Lindegaard 2022], the present cohort was characterized by an almost zero slope for CTV HR D 90 and a parallel shift of the line for D2cm 3 of the rectum by minus 5 Gy EQD2 . In total, 20 local failures were observed with 7/26 (27%) for AdSQ/AC and 13/182 (7%) for SQ (p=0.005). Local control at 5 years was 6% lower for non-included compared with included patients. Six patients recurred in boosted pelvic nodes, 14 in the elective target and 3 in both targets. 8/11 para-aortic recurrences were seen in patients not receiving para aortic radiotherapy and 3 was found inside the elective target. All boosted para-aortic nodes were controlled. Actuarial systemic control and overall survival was significantly lower in the non-included group.

Conclusion:

In this single centre experience, the planning aims of EMBRACE-II were achievable in real world patients even with very advanced disease to very high degree. However, delivery of concomitant cisplatin was problematic. Incidence of severe late effect was limited and local control was high in SQ but compromised in AdSQ/AC. Dose of EBRT and the criteria for para-aortic EBRT should be critically reviewed to improve regional control. A less toxic and more efficient treatment than concomitant cisplatin is needed to prevent systemic relapse in advanced disease and specifically to circumvent primary radioresistance in AdSQ/AC. Multicentre real-world data is required to confirm and a study is currently being planned.

Keywords: cervical cancer, real-world outcome, Embrace-II

References:

Pötter et al. Lancet Oncol. 2021 Apr;22(4):538-547

Pötter et al. Clin Transl Radiat Oncol. 2018 Jan 11;9:48-60.

Lindegaard et al. Int J Radiat Oncol Biol Phys. 2022 Jun 1;113(2):379-389.

1854

Poster Discussion

Clinical implementation of custom 3D-printed applicators for gynaecological HDR brachytherapy