ESTRO 2025 - Abstract Book

S864

Clinical - Gynaecology

ESTRO 2025

Material/Methods: EMBRACE-I (n=1318) was a prospective observational study conducted across 24 centres with a planned 5-year FU (1). Several centres reported survival and treatment-outcome data beyond this period. Centres that reported vital status for ≥70 months in ≥70% of patients were included in our current survival analysis. Among these, patients with available treatment-outcome data were included in the outcome analysis. Kaplan-Meier method was used to calculate the actuarial rates of analysed endpoints. We compared the extended FU results with the outcomes of the same cohort, obtained at the time of original EMBRACE-I publication, in 2021. Results: Survival data were available for 609 patients from 9 centres, and treatment-outcome information for 353 (58%) of them. Median FU was 84 and 108 months, respectively. Median age with interquartile range (IQR) was 50 (41, 61) years. WHO performance status was 0-1 in 598 (98%). Squamous-cell histology was present in 511 (84%); the rest were adenocarcinomas and adeno-squamous carcinomas. FIGO 2009 stage distribution was: IB1 (6.2%), IB2 (6.9%), IIA (3%), IIB (60%), IIIA (1%), IIIB (14%), IVA (1.5%), and IVB (7.2%; para-aortic nodes only); 52% had positive lymph nodes. Median CTV-T-HR at IGABT was 30 (22, 42) cm 3 ; and cumulative D90 (equivalent dose in 2 Gy/fraction) 91 (IQR: 87, 95) Gy. Cumulative D98 for the GTV was 102 (IQR: 94, 113) Gy. During extended follow up, 15/609 deaths and 9/353 relapses (2 local, 3 nodal, 4 distant) occurred. Actuarial 10-year Survival was 68%. Local, pelvic and systemic control at 5/10 years were: 92%/92%; 87%/86%, and 83%/82% (Figure).

Conclusion: Extended follow-up of the EMBRACE-I patients beyond 5 years demonstrated sustained survival, loco-regional control, and systemic control rates following chemoradiotherapy combined with MRI-guided brachytherapy. The number of local, pelvic, and systemic relapses was low, suggesting that follow-up beyond this period may be of limited value outside of clinical trials.