ESTRO 2025 - Abstract Book

S889

Clinical - Gynaecology

ESTRO 2025

References: Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clinical Nutrition 2021 -05;40(5):2898

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Digital Poster Geriatric patient with gynaecological neoplasia: a current challenge in adjuvant radiation treatment Francesca Gessoni, Angela Caroli, marco Gigante, Davide Tonussi, Marta Rossi, Maurizio Mascarin Division of Radiation Oncology, CRO, Aviano, IRCSS, Aviano, Italy Purpose/Objective: With the general ageing of the population, there is a concomitant increase in the incidence of oncological disease in older patients. The management of the geriatric cancer patient is complex and requires a careful balance of the risks and benefits of the proposed treatment. With regard to radiotherapy (RT), phenomena related to cellular ageing may slow down the repair processes of healthy tissue damaged by ionising radiation (IR), thus exposing the patient to increased side effects during treatment. The aim of this analysis is to evaluate the safety and tolerability of adjuvant (ADJ) radiotherapy treatments in elderly patients with gynaecological malignancies Material/Methods: Between 2019 and 2024, we treated 41 patients with gynaecological neoplasia aged ≥ 80 years and with performance status (PS) 0-2. All patients, after being discussed by multidisciplinary team, underwent ADJ radiation treatment after radical surgery. Of these 41 patients, 12 (29.26%) were diagnosed with vulvar neoplasia and 29 (70.74%) with uterine neoplasia. 32 (78.04%) of the patients with both histologies received external beam RT in 25 fractions with a cumulative dose between 45 Gy and 50 Gy. Of these patients, 10 (24.39%) with high-risk histology also received concurrent platinum based chemotherapy (CT). 9 patients (21.95%) received high dose rate (HDR) brachytherapy alone at a dose of 30 Gy in 5 fractions weekly. Acute toxicity was assessed at the end of treatment using the Common Terminology Criteria for Adverse Events (CTCAE Ed.4.0). Results: Overall, adjuvant radiotherapy was well tolerated. All patients who underwent HDR completed treatment with only 1 case of urinary toxicity (cystitis of non-infectious origin) grade (G)2. The following side effects were observed with external beam radiotherapy 1 case of urinary toxicity (cystitis of non infectious origin) G2, 1 case of proctitis G3, 1 case of intestinal toxicity (diarrhoea) G2. More cutaneous adverse events (radiodermatitis) were reported: 7 cases of radiodermatitis G2 and 2 cases of radiodermatitis G3. Two RTE treatments not associated with CT were not completed for proctitis and radiodermatitis, in both cases 20 of the planned 25 fractions were delivered. Conclusion: Adjuvant radiotherapy in elderly patients with PS 0-2 with gynaecological malignancies is safe and well tolerated, with an incidence of adverse effects comparable to that in younger patients. Therefore, advanced age cannot be considered a limiting factor in the choice of treatment to be proposed. On the contrary, in complex patients, the multidisciplinary approach allows the most appropriate treatment to be proposed for each patient.

Keywords: Gynaecological, Geriatric patient, Toxicity