ESTRO 2025 - Abstract Book

S783

Clinical - Gynaecology

ESTRO 2025

447

Digital Poster IMRT by Tomotherapy with concurrent weekly cisplatin followed by Brachytherapy HDR in locally advance cervical cancer (prospective study). sofiane mellouk, cheikh tayeb central hospital of the military army, military, Kouba , algiers, Algeria Purpose/Objective: On a global scale, cervical cancer remains one of the most prevalent cancers among women, . The purpose of this work is to evaluate the contribution of helical intensity-modulated radiation therapy via tomotherapy in 28 fractions for managing locally advanced squamous cell carcinoma of the cervix in terms of therapeutic effectiveness at one year through a prospective descriptive study of overall survival, and local, regional, and distant recurrence-free survival , And toxicity. Material/Methods: Our study involved 44 patients with locally advanced cervical neoplasia, treated as first-line therapy from August 2019 to May 2021. The treatment consisted of IMRT using tomotherapy, complemented by uterovaginal brachytherapy HDR , combined with concurrent chemotherapy. In dosimetry, we set the following objectives: at least 95% of the PTV_50.40 volume receiving a dose of 50.40 Grays should be covered by at least 95% of that dose, and at least 98% of this volume should receive 90% of the 50.40 Gray dose. Overdosage should be less than 107% of the 50.40 Gray dose. A post-treatment evaluation was carried out at 36 months to assess the effectiveness of this protocol in terms of overall survival, and survival without local, regional, and distant recurrence , And toxicity Results: The average age at admission was 57.55±8.7 years, 52.3%, were classified as IIB according to FIGO, 25% as IB3, 15.9% as IIIC1, and only 6.8% as IVA according to FIGO. The average dose received by 95% of the PTV_5040 volume was 97.83±1.30% with a median of 97.80%, and the extreme percentage ranged from 91.90% to 99.30%. The 95% confidence interval was [95.43 - 97.23]. No patient experienced an overdose exceeding 107% of the 50.40 Gray dose (the maximum was 105.00%), in line with our objective. The overall survival across all stages was 95.5%, with an average duration of 36.28 ± 0.5 months and a 95% confidence interval of [35.30– 37.26]. The local recurrence-free survival across all stages was 88.6%. The regional recurrence-free survival across all stages was also 88.6%, and the metastatic recurrence-free survival across all stages was 95.5%, The most common ≥ grade 3 acute toxicity was hematologic toxicity ( 25 %). The rates of ≥ grade 3 late toxicities were 3 % of proctitis, 1 % of urethral stricture .

Conclusion: Our study demonstrated the effectiveness of helical IMRT in managing locally advanced cervical cancer .

Keywords: cervix cancer , tomotherapy , brachytherapy

References: 1.Masson E. Épidémiologie du cancer du col de l’utérus. EM-Consulte. https://www.em consulte.com/article/11710/epidemiologie-du-cancer-du-col-de-l-uterus (accessed 30 May 2022)

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