ESTRO 2025 - Abstract Book

S213

Brachytherapy - Gynaecology

ESTRO 2025

Conclusion: Target dose reduction due to inferior displacement is more pronounced in the presence of needles. Rectum D2cc presents the most significant dose changes for both translational and rotational displacements. In comparison with translational displacements in inferior direction, dosimetric impact of rotational displacements in axial plane is minimal. This study further reassures that such dosimetric alterations do not affect the dose to clinical targets and pose insignificant effect clinically to OARs.

Keywords: Geneva applicator, dosimetry

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Digital Poster IMPACT OF VAGINAL DOSE ON SEXUAL QUALITY OF LIFE AND VAGINAL SYMPTOMS IN PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER (LACC). Théo Carrie 1 , Leonor Chaltiel 2 , Josiane Menard 3 , Amélie Lusque 2 , Justine Attal khalifa 1 , Eric Huyghe 4 , Thomas Brun 5 , Anne Ducassou 1 1 Radiation oncology, IUCT-Oncopole, Toulouse, France. 2 Statistics, IUCT-Oncopole, Toulouse, France. 3 Supportive care, IUCT-Oncopole, Toulouse, France. 4 Urologic surgery, CHU, Toulouse, France. 5 Physics, IUCT-Oncopole, Toulouse, France Purpose/Objective: Cervical carcinoma remains a significant health concern, with treatments often leading to long-term vaginal morbidity and sexual dysfunction. Our study aimed to evaluate the association between radiation dose to the vagina with vaginal morbidity and sexual function, in patients with locally advanced cervical carcinoma. Material/Methods: Dosimetric data during both external beam radiotherapy and brachytherapy were analysed retrospectively in 56 patients from the prospective monocentric Feminicol study (NCT03956498). All patients were diagnosed with locally advanced cervical carcinoma, treated with concomitant radio-chemotherapy followed by BT and enrolled between October 2019 and December 2020. The Feminicol study evaluated the sexual quality of life with sexologic supportive care defined by the evolution of FSFI score 12-month after treatment as primary objective and QLC CX24, QLC-Q30 score and several vaginal side effects as secondary objectives. Medical and sexological consultations were made at inclusion and repetitively 2 months and 12 months after treatment. We retrospectively analysed in this new study association between dose to the vaginal wall and to selected points in the vagina, with vaginal morbidity and sexual quality of life. Results: Median age was 54 (range 31-77), 34 were in a relationship (61.8%). Majority of patients were stage IIIC (N=31, 58.5%), or IIB (N=14, 26.4%), FIGO 2018. At 1 year, among patients who received 53Gy EqD2 or more at PIBS+2, none (0/15 patients) conserved sexuality according QLQ-cx24, vs 7 (7/24) when dose <53Gy ( p =0.031). At 1 year, median of the mean dose delivered to the vagina was 42.9Gy (33.7;52.5) in patients with a conservative sexuality according QLQ-cx24, vs 50.3Gy (24.1-85.2) in others (p=0.066). Median dose at PIBS-2 EQD2 was 15.5 Gy (2.20;62.40) in patients with all grades vaginal stenosis vs 4.6 Gy without stenosis (2.50;46.50), p=0.064. A cut-off of 5 Gy was statistically significant (24% of vaginal stenosis with dose to PIBS-2 <5Gy vs 52.4% with >=5 Gy; p =0.047). After review, this dose was delivered predominantly in EBRT, sometimes without any clinical justification.