ESTRO 2024 - Abstract Book

S1036

Clinical - Gynaecology

ESTRO 2024

4 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Radiation Oncology, Rome, Italy. 5 Università Cattolica del Sacro Cuore, Radiation Oncology, Campobasso, Italy. 6 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy. 7 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Scienze della salute della donna, del bambino e di sanità pubblica, Rome, Italy

Purpose/Objective:

Vaginal carcinoma (VC) is a rare malignancy accounting for 1% to 2% of all gynecological cancers. Although surgery yields good local control (LC) and overall survival (OS) in selected cases of vaginal intraepithelial neoplasms and early (I–II) stages of VC, definitive radio-chemotherapy (RCT) followed by interventional radiotherapy (IRT, also called brachytherapy, BT) is considered an excellent option. The aim of this study was to report the results of our mono-institutional series of vaginal cancer patients treated with radio-chemotherapy followed by image- guided IRT.

Material/Methods:

We retrospectively analysed 31 patients with primary vaginal cancer who received RCT followed by IRT with curative intent between January 2019 and December 2022. 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. 14 patients were stage II, 13 patients stage III and 4 stage IVB (International Federation of Gynecology and Obstetrics stages 2008). The median total dose of external beam RT was 45Gy (range 45Gy-60Gy). OncentraBrachy treatment planning system and a Flexitron (Elekta, Stockholm, Sweden) device with a 192-Ir source were used for IRT treatment. The median IRT total dose was 28 Gy (range 10Gy-28Gy). All patients received cisplatin chemotherapy. The median duration of follow-up was 18 months (3-65 months), while the median Overall treatment time (OTT) was 62 days (28-97 days). One-year LC, DMFS, PFS and OS rates were 88.2%, 96.8%, 88.1%, 96.3%, respectively (Figure 1). Acute toxicity was registered in 23 patients: 12 cases of cutaneous toxicities (6G1, 5G2, and 1 G3), 11 cases of genito-urinary ones (8 G1, 3 G2), 8 gastro-intestinal ones (2G1, 6G2). Regarding late toxicities, only vaginal ones were registered: one G3 stenosis, three G2 stenosis, 7 G1 stenosis, one G1 teleangectasia, and 3 G1 atrophy.

Conclusion:

In this series, definitive radio-chemotherapy followed by image-guided interventional radiation therapy was an effective treatment modality for primary vaginal cancer.

Keywords: Radio-chemotherapy ; brachytherapy, vaginal cancer