ESTRO 37 Abstract book

ESTRO 37

S423

Purpose or Objective The objective of this retrospective study was to evaluate patient-reported distress in locally advanced cervical cancer patients (pts) treated with definitive chemoradiation (CRT) using the validated Edmonton Symptom Assessment System (ESAS) questionnaire. Material and Methods Cervical cancer pts treated with definitive CRT who completed the ESAS at clinical visits between November 2011 and August 2016 were identified. Inclusion criteria consisted of providing research consent and completing at least 2 questionnaires, including baseline. The ESAS evaluates 9 individual symptoms that pts rate from 0 to 10 and are summed to provide a total score. Higher scores indicate higher distress. Individual symptoms and total scores at baseline, end of treatment and follow-up were collected. Mean total scores were calculated for all time-points and compared to baseline using a paired t- test. The ESAS minimal clinically important difference (MCID) for total score reflecting treatment-induced changes expected to be meaningful for the patient is defined as a change of 3-points for improvement and 4- points for deterioration. The MCID for total score was calculated. Demographic, treatment and clinical outcome data were also extracted. Results 98 pts were initially identified and 52 pts met our inclusion criteria and formed our study cohort (Table 1). Median follow-up was 16 mos (range: 4-55 mos). Total ESAS scores continually decreased over time: mean scores at baseline (n=52), end of treatment (n=38), 6 wks (n=26), 6 mos (n=35) and 12 mos (n=30) were 22.6, 20.0, 14.3, 13.2 and 13.9, respectively. There was no difference in total score at baseline compared to end of treatment (p=0.50), but there was a significant improvement at 6 wks, 3 mos and 6 mos compared to baseline (p=0.03, p=0.03 and p=0.002, respectively). However, there were no differences at 12 mos (p=0.78). When compared to baseline, the total score MCID for improvement increased from treatment completion up to 6 mos then stabilized (Figure 1). Table 1: Baseline patient demographic and treatment characteristics. Median age at diagnosis (yrs) (range) 46 (30-77) Median time treatment completion (days) (range) 44 (34-93) FIGO Stage, n (%) IB IIA/B IIIIA/B 16 (31) 27 (52) 9 (17) Nodal involvement, n (%) 19 (37) Median brachytherapy dose (cGy) (range) 2800 (2800- 4000) Brachytherapy technique, n (%) Intracavitary Intracavitary + Interstitial 30 (48) 22 (42) Recurrences, n (%) Local Regional Distant 7 (14) 9 (17) 18 (35) Median EBRT Dose (cGy) (range) 4500 (4000- 5040)

Conclusion Locally advanced cervical cancer pts treated with definitive CRT show an improvement in distress (total ESAS score) from baseline to 6 mos post-treatment with subsequent stabilization and return to baseline at 12 mos. Further studies correlating co-variates, such as recurrence and toxicity, are underway. Prospective collection of cervix cancer specific patient-reported outcomes should better inform and guide survivorship planning. PO-0812 Definitive radiotherapy and brachytherapy for inoperable endometrial cancer: a retrospective report D. Najjari Jamal 1 , C. Gutierrez Miguelez 1 , S. Marin i Borràs 1 , M. Laplana Torres 1 , F. Pino 2 , S. Moreno 2 , J. Pera Fabregas 1 , F. Guedea Edo 1 1 Insitut Català d'Oncologia ICO Hospitalet, radiation oncology, Hospitalet de Llobregat, Spain 2 Insitut Català d'Oncologia ICO Hospitalet, Medical Physics, Hospitalet de Llobregat, Spain Purpose or Objective To report our experience and survival rates after definitive external beam radiotherapy (EBRT) and/or brachytherapy (BT) in medically inoperable endometrial cancer patients. Material and Methods From 1999 to 2017, 88 medically inoperable patients diagnosed with endometrial cancer were identified. Mean age at diagnosis was 70 years (range 45-86 years). The FIGO stage at diagnosis was I in 56%, II in 20% and III in 17% of patients. The most common histology was adenocarcinoma (80%) and the proportion of histological grades (G) were 53% for G1, 19% for G2 and 22% for G3 (missed data in 6% of the cohort). The causes of inoperability were mainly morbid obesity (46%), but 24% of the cohort were considered inoperable due to medical contraindications. Patients underwent definitive radiotherapy (either EBRT with 3D conformal technique or exclusive BT or combined treatment EBRT+ BT) ± chemotherapy, as follows: EBRT: 3 patients, BT: 14 patients, EBRT+BT: 53 patients. BT was performed mainly with uterine double catheter applicator, and the dose rates were LDR, PDR or HDR (>50%). The nominal prescribed dose to the PTV ranged from 36Gy to 60Gy. Rectal and urinary morbidity was reported with physician assessed common toxicity criteria for adverse events (CTCAE v.3) in regular follow-up. Crude incidence rates, prevalence rates and actuarial estimates using the Kaplan-Meier method were analyzed. Results Information for analysis was available in 70 patients with a median follow-up of 40 months (range 6-2 13 months). Local control at 5 years was 70%, with a nodal and distant failure of 24% and 22%, respectively. The 5-year overall survival (OS) was 44% (CI 95% 32-56) and specific-disease survival (SDS) was 63% (CI 95% 49-80). Prevalence rates of chronic rectal toxicity were G1:10%, G2:2%, G3:7.1% and G4:1.4%. Chronic urinary toxicity regarding incontinence was 14.3% for G1, 4.3% for G2, 1.4% for G3. No G4 morbidity occurred but 1 patient presented G5 toxicity (fistula) Urinary frequency G≥1 fluctuated.

Figure 1: Proportion of patients with a MCID from baseline for total score.