ESTRO 36 Abstract Book

S687 ESTRO 36 2017 _______________________________________________________________________________________________

RECIST ver 1.1. Acute toxicity was assessed based on CTCAE 4.0 and RTOG grading of Acute toxicities. Results Patients who tolerated treatment well without acute radiation or chemotherapy induced morbidity were comparable in both arms (62.06%(A) and 27.7%(B)) and (55.17(A)% 18.1%(B)) respectively. Grade I/II proctitis was seen in 5 patients(17.2%) in Arm A and 4 patients in Arm B(13.7%) Diarrhea requiring medication (Grade II) was seen only in 1 patient conventional group. None of the patients in the concomitant boost group had Genitourinary morbidity while 1 patient developed GU morbidity in the conventional group. Development of Gr I Skin reaction was comparable in both groups. The local control rates were 72.4% vs 51.7% in favor of the control group. Conclusion The use of concomitant boost in the management of locally advanced cervical cancers is not widely practiced due to the general perception that the toxicity profile may be more due to dose escalation. This study shows that the acute toxicity profile of concomitant boost using conformal therapy is comparable to that of conventional fractionated radiotherapy with better local control rates. Further randomized studies need to be carried out to assess the long term outcome of concomitant boost in locally advanced cervical cancer. EP-1292 Prognostic factors of patients with cancer of uterine cervix in chemo-irradiation era. F. James 1 , A. Kumar 1 , S. Mathews 1 , J. Joseph 1 , P.S. George 2 , A. Mathew 2m M. Anjanappa (India) 1 Regional Cancer Centre- Trivandrum, Radiation Oncology, Trivandrum, India 2 Regional Cancer Centre- Trivandrum, Biostatistics and Epidemiology, Trivandrum, India Purpose or Objective Cancer cervix is the second commonest female cancer in India and accounts for 20.2% cancer mortality in women. Majority of the patients present with advanced stage in our centre. The study aims to identify factors affecting the outcome of cancer cervix treated in Chemo-irradiation era. Material and Methods From a surveillance study of 1046 cervical cancer patients treated at our centre, between January 2006 to December 2008, data of 790 patients who had radical radiotherapy were taken . Known prognostic factors like stage, age , histological type, use of chemotherapy and overall duration of treatment were taken for the study. The survival rate was analysed using the Kaplan-Meier method. Survival data between groups were compared with the Log-rank test for univariate analysis and Cox regression analysis for multivariate analysis. Results For the 790 patients, median age was 54.9 years (28-82) with standard deviation(SD) of 10. Median follow up was 59 months (4-93) with SD of 20.5.The five year survival probability is 70.3%.The probability of five year survival is 81.2%,80.1%,57.1%,26.7% for stage 1,2,3 and 4 respectively. For patients younger than 40 , 40-70 and older than 70 years, the probability of five year survival are 68%,71.6% and 52.7% respectively. Patients who had squamous cell carcinoma did better with 72% than those with adeno carcinoma with 59.2% survival probability. The patients who had concurrent chemotherapy (two third of patients) also did better (74.2% compared to 62.3%).Regarding overall treatment time , <8,<9 and <10 weeks were tested. The survival probability decreased significantly when the treatment extended to 9 weeks or more (76.1% vs 63.9%). This remained significant whether chemotherapy was used or not. In univariate analysis, stage, age, histological subtype, use of chemotherapy and treatment duration less than 9

weeks were significant predictors of survival. In the multivariate analysis, earlier stage of disease ( stage 2 or less ) , use of chemotherapy, and duration of treatment less than 9 weeks were significant. Conclusion For patients receiving radical radiation for cancer cervix , stage, concurrent chemotherapy and finishing treatment within 9 weeks are significant factors for survival. EP-1293 Clinical outcome of prophylactic PAN irradiation for locally advanced cervical cancer K. Fukuda 1 , Y. Nishimura 1 , K. Nakamatsu 1 1 Kindai University Faculty of Medicine, radiation oncology, Osaka-Sayama, Japan Purpose or Objective The aim of this study is to analyze the outcomes of curative irradiation for locally advanced cervical cancer with or without prophylactic irradiation for para-aortic lymph nodes (PAN). Material and Methods Between 1999 and 2015, 70 patients with locally advanced cervical cancer treated with curative radiation therapy were analyzed. The median age was 61 years old. From 1999 to 2008, 33 patients were performed prophylactic irradiation for PAN after the treatment of whole pelvic region (PAN+ group). For PAN area, all patients were treated with 2-4 beams using 10-MV X-ray to a total dose of 45Gy /25fr or 50.4Gy /28fr. After 2008, prophylactic irradiation was not performed for 37 patients (PAN-group). Of 70 patients, 44 patients were performed concurrent chemo therapy. All patients were classified according to FIGO staging system. Our cohort includes 47 patients of stage 3 and 23 patients of stage 4. The acute and late complications were evaluated according to CTCAE ver. 4.0. Results For all patients, 5-year overall survival rate was 53%. For PAN+ group and PAN- group, relapse from PAN area were observed for 3 patients each (9%, 8%). There was no difference between two groups. An acute gastro-intestinal toxicity more than grade 2 were observed in 6 patients from PAN+ group and 1 patient from PAN- group. A late gastro-intestinal toxicity more than grade 2 was observed in 5 patients and 4 patients from PAN+ group and from PAN- group respectively. Conclusion Prophylactic irradiation for PAN did not prevent local recurrence from PAN area. EP-1294 Interfractional motion of vaginal cuff after hysterectomy in gynecologic cancer S. Chun 1 , K.Y. Eom 2 , H. Kim 3 1 SNUH, Radiation Oncology, SEOUL, Korea Republic of 2 Bundang Hospital- Seongnam- Korea, Radiation Oncology, Seongnam, Korea Republic of 3 Soonchunhyang University Hospital, Department of Radiation Oncology/Cyberknife center, Seoul, Korea Republic of Purpose or Objective To identify relationship between bladder and rectal volume changes during radiotherapy with vaginal stump movement. Also by calculating vaginal stump movement, adequate PTV margin for vaginal stump can be determined. Material and Methods Ten patients with cervical or endometrial cancer were enrolled prospectively. All patients received surgery with curative aim and adjuvant radiotherapy. Patients took cone beam CT (CBCT) once a week with radiocontrast soaked gauze and radiopaque markers to visualize vaginal stump. Each patient underwent total 6 CT imaging acquisition including one simulation CT and 5 CBCTs. All CBCT images of each patient were transported to initial