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ESTRO 36 2017
_______________________________________________________________________________________________
Conclusion
Treatment had a profound impact on QoL. For some
systems this was temporarily, other symptoms persisted
during further follow-up. End of external beam treatment
is the most sensitive time point to measure future
improvements in online adaptive radiotherapy with a PotD
approach.
OC-0055 Local failures after radiochemotherapy and
MR-image-guided brachytherapy in cervical cancer
patients
M. Schmid
1
, C. Haie-Meder
2
, U. Mahanshetty
3
, I.M.
Jürgenliemk-Schulz
4
, B. Segedin
5
, P. Hoskin
6
, C. Kirisits
7
,
J. Lindegaard
8
, K. Tanderup
8
, R. Pötter
7
1
Medizinische Universität Wien Medical University of
Vienna, Department of Radiation Oncology, Vienna,
Austria
2
Gustave Roussy, Department of Radiotherapy, Paris,
France
3
Tata Memorial Hospital, Department of Radiation
Oncology, Mumbai, India
4
Utrecht University, Department of Radiation Oncology,
Utrecht, The Netherlands
5
Institute of Oncology, Department of Oncology,
Ljubiljana, Slovenia
6
Mount Vernon Cancer Center, Department of
Radiotherapy, Northwood, United Kingdom
7
Medical University of Vienna, Department of Radiation
Oncology, Vienna, Austria
8
Aarhus University Hospital, Department of Oncology,
Aarhus, Denmark
Purpose or Objective
To report patterns of local failure (LF) after
radiochemotherapy and MR-image-guided adaptive
brachytherapy (IGABT) in patients with loc ally advanced
cervical cancer (LACC) observed within the international
prospective observational multicenter study „EMBRACE“
(An international study on MRI-guided brachytherapy in
locally advanced cervical cancer,
www.embracestudy.dk).
Material and Methods
From 2008-2015, 1419 patients with LACC treated with
radiochemotherapy
and
MR-IGABT
(GEC-ESTRO
recommendations) were included in the study. 1230
patients with completed treatment without major
protocol violations (n=73) and with at least one follow up
examination were available for this analysis (106
excluded). A LF was defined as incomplete remission in
case of persistent disease 3 months after treatment which
did not resolve at six months and as local recurrence after
complete remission in case of recurrent disease. LFs were
described based on their relation to (1) the clinical target
volumes (CTV) and to (2) infiltrated organs /
compartments.
Results
After a median follow-up of 25 months 80 local fai lures
(24 incomplete remissions and 56 local recurrences) were
observed. Synchronous nodal or distant metastases were
reported in 42 patients (52%, not reported: 5%). Median
time to local recurrence was 11.5 months, 47 (86%)
occurred within 24 months. Information about the location
of LF was available in 63 patients (79%): The cervix and
uterus were involved in 50 patients (80%), the proximal
parametria in 8 patients (13%), the distal
parametria/pelvic wall in 18 patients (29%), the vagina in
18 patients (29%), the urinary bladder in 12 patients (19%)
and the rectum in 2 patients (3%), respectively (more than
one location possible). An allocation to CTV was possible
in 53 patients (66%): In 51% the LF were located inside the
high risk (HR) CTV (n=27), in 17% inside the intermediate
(IR) CTV (n=9) and in 30% inside the HR+IR CTV (n=16). 2%
was not related to the CTVs (n=1).
Conclusion
Local failures occur in a very limited number of patients
after radiochemotherapy and IGABT. They are in about
50% synchronous with nodal or distant disease. The vast
majority occurs within two years. Most patients fail
locally within the HRCTV and IR CTV.
OC-0056 Bowel morbidity in cervix cancer after
RCHT+IGABT; physician and patient reported outcome -
EMBRACE
N.B.K. Jensen
1
, K. Kirchheiner
2
, L.U. Fokdal
1
, J.C.
Lindegaard
1
, C. Kirisits
2
, R. Mazeron
3
, U. Mahantshetty
4
,
B. Segedin
5
, I.M. Jürgenliemk-Schulz
6
, P.J. Hoskin
7
, R.
Pötter
2
, K. Tanderup
1
1
Aarhus University Hospital, Department of Oncology,
Aarhus C, Denmark
2
Medical university of Vienna / General Hospital of
Vienna, Department of Radiation Oncology-
Comprehensive Cancer Center, Vienna, Austria
3
Gustave-Roussy, Department of Radiotherapy, Villejuif,
France
4
Tata Memorial Hospital, Department of Radiation
Oncology, Mumbai, India
5
Institute of Oncology Ljubljana, Department of
Radiotherapy, Ljubljana, Slovenia
6
University Medical Centre Utrecht, Department of
Radiation Oncology, Utrecht, The Netherlands
7
Mount Vernon Hospital, Cancer Centre, London, United
Kingdom
Purpose or Objective