ESTRO 2025 - Abstract Book

S814

Clinical - Gynaecology

ESTRO 2025

Keywords: carbon ion RT, proton beam RT, reirradiation

References: 1. Shiba S. et al (2017). Clinical Impact of Re-irradiation with Carbon-ion Radiotherapy for Lymph Node Recurrence of Gynecological Cancers. Anticancer research, 37(10), 5577–5583 2. Pollock A. et al (2023). Clinical Outcomes of Intensity Modulated Proton Therapy Reirradiation for Gynecologic Malignancies. Advances in radiation oncology, 8(4), 101191 3. Critelli P. et al (2023). Outcomes and toxicity in re-irradiation of gynecologic cancer: Systematic review of the Italian association of radiation and clinical oncology (AIRO). Gynecologic oncology, 179, 33–41.

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Digital Poster Sexual quality of life after definitive radio (chemo) therapy and CT image-guided adaptive brachytherapy for locally advanced cervical cancer Beatrice Anghel 1,2 , Anca Daniela Stanescu 3,2 1 Radiation Oncology, Sanador Oncology Center, Bucharest, Romania. 2 Gynaecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 3 Gynaecology, Bucur Maternity Hospital, Bucharest, Romania Purpose/Objective: Image-guided adaptive brachytherapy (IGABT) is a new concept in the treatment of locally advanced cervical cancer (LACC). When magnetic resonance imaging guidance is not available, computed tomography (CT) is an universally recognized imaging modality. Three-dimensional CT- IGABT has led to important advances in terms of both clinical outcomes and morbidity. So far, little has been reported about the early or late vaginal morbidity and sexual quality of life remains a sensitive subject. Material/Methods: Prospective analysis was performed on patients treated for cervical cancer at the Sanador Oncology Center from January 2020 to June 2022. A total of 180 patients received external beam radiation, chemotherapy and brachytherapy. All patients were treated with high dose brachytherapy, IC or hybrid (IC+IS) technique (90%). A median follow-up time of 13 months and information on vaginal morbidity were included. Quality of life was prospectively assessed using 2 questionnaires: EORTC QLQ-C30 and EORTC cervical cancer module 24 (CX24) at baseline, every 3 months during the first year then at 6 months in the second year and vaginal morbidity recorded according to the Common Terminology Criteria for Adverse Events, version 3, regarding vaginal stenosis, dryness, mucositis, bleeding, fistula, and other symptoms. Results: At 18 months, severe vaginal morbidity (grade ≥3) was 10 %. However, mild and moderate vaginal symptoms were recorded at 6 months (grade ≥1, 85%; grade ≥2, 25%). After 12 months, frequently observed was vaginal stenosis (length), followed by vaginal dryness. Vaginal bleeding and mucositis were mainly mild and infrequently reported. Regular vaginal dilatation was associated with less stenosis and/ or bleeding. The patients having a partner have been less reluctant to get education and sexual rehabilitation. Conclusion: Hybrid technique in LACC achieves good local control in large tumours after CRT improving target volume coverage with low rates of acute morbidity. Severe vaginal morbidity within the first 2 years after CRT including IGABT with IC/IS techniques for LACC is limited, but mild to moderate vaginal toxicity si still pronounced and affects sexual health. In order to improve sexual quality of life, early holistic support is needed for rehabilitation.

Keywords: cervical cancer, sexual quality of life, IGABT