ESTRO 36 Abstract Book

S689 ESTRO 36 2017 _______________________________________________________________________________________________

Africa. Hyperthermia is a known radiosensitiser used to treat cervical cancer with improved clinical outcomes and survivals. The aim of this study is to determine the clinical effects of the addition of modulated electro-hyperthermia to the standard treatment protocols for locally advanced cervical cancer patients in state healthcare in South Africa.late toxicity and 2 year survival. Material and Methods This ongoing phase III randomised clinical trial is being conducted at the Charlotte Maxeke Johannesburg Academic Hospital. The study aims to enrol 236 female participants with FIGO stage IIB (initial distal parametrium involvement) to IIIB cervical cancer (bilateral hydronephrosis excluded). Participants are being randomised into a 'Hyperthermia” group (electro- hyperthermia plus chemoradiation) and a 'Control” group (chemoradiation alone). Randomisation stratum: HIV status, age and stage of disease. Participants in both groups are receiving 25 fractions of 2Gy external beam radiation, 3 doses of high dose rate brachytherapy (8Gy) and up to 3 doses of cisplatin (80mg/m 2 ). Two local mEHT sessions are administered per week prior to radiotherapy in the Hyperthermia group. Local disease control is assessed by Positron Emission Tomography (PET) scans and early toxicity is graded according to the CTCAE version 4. Results We report on the interim analysis on local disease control and early toxicity of the first half of the recruited participants in our study. Early results show an improvement in local disease control with no unexpected early toxicity in the hyperthermia group. Conclusion There is a positive trend in the Hyperthermia group suggesting that the addition of hyperthermia may be beneficial in locally advanced cervical cancer patients. EP-1298 Radiotherapy in invasive vaginal carcinoma: a systematic review M. Buwenge 1 , G. Macchia 2 , M. Ferioli 1 , L. Giaccherini 1 , A. Arcelli 1,3 , A. Galuppi 1 , S. Cammelli 1 , A.M. Perrone 4 , P. De Iaco 4 , M. Boccardi 2 , L. Tagliaferri 5 , G. Ferrandina 6 , F. Deodato 2 , S. Cilla 7 , G.P. Frezza 3 , A.G. Morganti 1 1 University of Bologna, Radiation Oncology Center- Department of Experimental- Diagnostic and Speciality Medicine - DIMES, Bologna, Italy 2 Fondazione di Ricerca e Cura "Giovanni Paolo II", Radiotherapy unit, Campobasso, Italy 3 Ospedale Bellaria, Radiotherpy Department, Bologna, Italy 4 Sant'Orsola-Malpighi Hospital, Gynecologic Oncology Unit, Bologna, Italy 5 Policlinico Universitario "A.Gemelli"- Università Cattolica del Sacro Cuore, Department of Radiotherapy, Rome, Italy 6 Policlinico Universitario "A. Gemelli"- Università Cattolica del Sacro Cuore, Gynecologic Oncology Unit, Rome, Italy 7 Fondazione di Ricerca e Cura "Giovanni Paolo II", Medical Physics Unit, Campobasso, Italy Purpose or Objective Primary vaginal carcinoma (VC) is rare, accounting for 1-2 % of all gynaecological malignancies. Being rare, most studies are retrospective and few trials are available in literature based on modern radiotherapy (RT) treatments. Therefore, aim of this analysis was to systematically review the recent literature on RT in VC to better define its role. Material and Methods From Pubmed database, a literature search strategy was performed using the PRISMA guidelines including published prospective and retrospective trials on either form of RT in invasive VC published between 2000 and 2016. Editorials, letters and case reports were excluded. Results

Recorded data were number of patients, period of enrolment, median follow up, treatment characteristics and treatment outcomes. A total of 548 patients (median age 65 years) from 10 studies were analyzed based on selection criteria. Most studies were small retrospective series on patients treated between 1959 and 2014 with different methods in terms of dose, fractionation, treatment techniques, previous surgery, concurrent chemotherapy, combination with brachytherapy (BT), and evaluation modalities. Concurrent chemotherapy was used in 4 studies and 3 papers included postoperative RT. In most studies (8) external beam RT plus BT boost was used. Various RT techniques were used in 6 studies (AP/PA, box- technique, IMRT, VMAT), while in 4 studies the technique was not reported. In only 3 studies IMRT (2) or VMAT(1) were used. Acute and late grade ≥ 3 toxicities ranges were 2.4-17.0% and 2.4-17.8%, respectively. Median 5-year DFS was 77.3% (I-II stage; 25.0-92.4%, III-IV stage; 0.0-48.5%). Median 5-year OS was 58.4% (I- II stage; 25.2-83.7%, III-IV stage; 0.0-50.5%) with significant impact of stage on patients outcome. Conclusion Only few studies have been published in the last decade with large heterogeneity in terms of treatment characteristic and evaluation criteria. Clinical results were strongly influenced by tumor stage. Prospective studies based on advanced RT techniques are needed to better define the role of modern RT in these patients and to improve outcome in advanced stages of VC. EP-1299 Nomogram prediction for overall survival of patients diagnosed with cervical cancer. S. Jagadeesan 1 1 Kidwai memorial institute of oncology, radiation oncology, Bangalore- Karnataka, India Purpose or Objective Nomograms are predictive tools that are widely used for estimating cancer prognosis. The aim of this study was to develop a nomogram for the prediction of overall survival (OS) in patients diagnosed with cervical cancer. Material and Methods Cervical cancer databases of our institutie were analysed. Overall survival was defined as the clinical endpoint and OS probabilities were estimated using the Kaplan-Meier method. Based on the results of survival analyses and previous studies, relevant covariates were identified, a nomogram was constructed and validated using bootstrap cross-validation. Discrimination of the nomogram was quantified with the concordance probability. Results In total, 42 consecutive patients with invasive cervical cancer, who had all nomogram variables available, were identified. Mean 5-year OS rates for patients with International Federation of Gynecologists and Obstetricians (FIGO) stage IA, IB, II, III, and IV were 99.0%, 88.6%, 65.8%, 58.7%, and 41.5%, respectively. two cancer- related deaths were observed during the follow-up period. FIGO stage, tumour size,tumour type histologic subtype, ph, parametrial involvement, endometrial invasion and organ involvement were selected as nomogram covariates. In our study, the total bad prognostic score mean value is 12. So, we derived more than 12 as high risk, more than 10-12 as intermediate risk and; less than 10 as low risk group. Based on predictor Lin‘s statistic concordance index value is 0.61. The normal value of C index is ±1. In our study we had achieved perfect concordance index value which is suggestive of perfect Based on eight easily available parameters, a novel statistical model to predict OS of patients diagnosed with cervical cancer was constructed and validated. The model was implemented in a nomogram and provides accurate prediction of individual patients' prognosis useful for normogram. Conclusion