ESTRO 36 Abstract Book

S684 ESTRO 36 2017 _______________________________________________________________________________________________

Leukocytosis and neutrophilia were defined as a leukocyte count or a neutrophils count exceeding 10,000 and 7,500/µl, respectively. Results 113 patients were identified. All patients received a pelvic irradiation concomitant with chemotherapy, extended to the para-aortic area in 13 patients with IVB disease. Neutrophilia and leukocytosis were significant univariate prognostic factors for poorer local failure-free survival (p = 0.000 and p = 0.002, respectively), associated with tumor size, high-risk clinical target volume (HR-CTV) and anemia. No effect was shown for distant metastases but leukocytosis and neutrophila were both poor prognostic factors for in-field relapses (p = 0.003 and p < 0.001). In multivariate analysis, HR-CTV volume (p = 0.026) and neutrophils count > 7,500/µl (p = 0.018) were independent factors for poorer survival without local failure, with hazard ratio (HR) of 3.1. Conclusion Neutrophilia is a significant prognostic factor for local relapse in locally advanced cervical cancer treated with MRI-based IGABT. This biomarker could help identifying patients with higher risk of local relapse and requiring dose escalation. EP-1286 MRI vs clinical assessment in staging and prediction of recurrence in carcinoma cervix treatment A. Mintu Mathew 1 , S. Aravindh Anand 1 1 Goverment Medical College Trivandrum, Radiotherapy, Trivandrum, India Purpose or Objective This prospective study aimed to evaluate the correlation between MRI and clinical assessment in staging and response evaluation of locally advanced carcinoma cervix. It also aimed to assess the role of MRI as a predictor of recurrence free survival. Material and Methods 58 women with locally advanced carcinoma cervix were studied from January 2014 to October 2015 after obtaining informed consent. After MRI abdomen & pelvis ,patients were started on chemo-radiation. Pelvic External beam radiation (EBRT) to a dose of 45Gy/23 fractions with concurrent weekly cisplatin 40mg/m2 was given, followed by intracavitary brachytherapy 7Gy/fraction x 3 fractions weekly once. Treatment response was assessed as per RECIST criteria clinically and radiologically with MRI after 4-6 months. Both pre and post treatment radiological evaluation was done by independent radiologists. Any suspected recurrence was subjected to MRI assessment and biopsy for proof. Results At a median follow up of 12 months, Kaplan Meir survival analysis showed a recurrence free survival of 69.6%. The hazard ratio of recurrence was 8.667 times between non- responders and responders by MRI (p=0.001. 95% CI 2.82 to 35.1)and 1.667 between non responders and responders by clinical assesment (p=0.438). Kaplan Meir analysis for recurrence free survival separately done for patients who had achieved complete response (on MRI) vs. those who did not, showed only 10.7% percent of the responders and 50 % of the non- responders had recurrence. When assessing the clinical response , it was seen that the 27.9% of the responders and 38.5 % of the non-responders had recurrence showing MRI was more useful in predicting recurrences. The kappa analysis showed a value of 0.18 for initial staging and 0.08 for response evaluation was which signified poor agreement between MRI and clinical assessment in both staging and response evaluation. Bland-Altman analysis revealed a mean difference of agreement of 0.28 (0 being complete agreement) between MRI and clinical response evaluation [p= 0.002]

. Conclusion

There are significant differences both in staging and response evaluation between FIGO and MRI in carcinoma cervix. In assessment of response to the standard treatment, MRI was found to be a better predictor of recurrence and thus ultimately, the outcome of treatment .This study proves that MRI may be used as a tool in assessment of treatment response thus predicting patients who may go for treatment failure, and may benefit from close follow up and early salvage. K. Woo 1 , L. Davis 2 , M. Light 3 , L. Croydon 4 , M. Powell 5 1 University College London Hospital, Oncology, London, United Kingdom 2 Kings College Hospital, Oncology, London, United Kingdom 3 Guys and St Thomas Hospital, Oncology, London, United Kingdom 4 Institute of Cancer Research, Oncology, London, United Kingdom 5 St Bartholomew's Hospital, Radiotherapy, London, United Kingdom Purpose or Objective Cervical cancer is the second most common cancer in women worldwide, 80% of which is treated primarily with radiotherapy. Aim: To evaluate the outcome of patients with cervical cancer treated with radical radiotherapy either as primary treatment or given adjuvantly (+/- chemotherapy) at single cancer centre between 1999 and 2009 in terms of overall survival (OS), acute and late EP-1287 10-Year outcomes on patients receiving radical radiotherapy for cervicalv cancer