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patients had histologically proven non-metastatic ASCC
and all underwent curative CRT. There were no
statistically significant differences between the test and
replication cohorts in terms of baseline demographics and
cancer characteristics. The majority of patients had
advanced staged disease at presentation - 28/40 patients
in the test cohort and 23/30 were AJCC stage III (IIIA or
IIIB).11/40 patients in the test cohort and 7/30 patients in
the replication cohort experienced disease recurrence.
Median follow-up was 25 months.Using the test cohort, we
identified seven baseline TA parameters that were the
most influential predictors of disease recurrence at
baseline (Figure 1) with FDR p-value <0.15 (<0.02
unadjusted). These parameters were then independently
tested using the replication cohort, with four out of seven
parameters retaining statistically significant predictive
value with replication FDR p-value <0.05. Finally, a pooled
analysis of data showed yielded a highly significant FDR p-
value <0.01 for five out of seven TA parameters tested.
Conclusion
Quantitative MR based TA parameters, in particular those
previously associated with active inflammation, show
promise in assessing the risk of anal cancer recurrence at
baseline.
Poster: Clinical track: Gynaecological (endometrium,
cervix, vagina, vulva)
PO-0708 Patterns of Care in the Netherlands for
Radiotherapy of Women with Locally Advanced
Cervical Cancer
P. De Boer
1
, I.M. Jürgenliemk-Schulz
2
, W. H.
1
, A.C.C. De
Leeuw
2
, R. Dávila-Fajardo
2
, C.R.N. Rasch
1
, B.R. Pieters
1
,
L.J.A. Stalpers
1
1
Academic Medical Center, Radiation Oncology,
Amsterdam, The Netherlands
2
University Medical Centre Utrecht, Radiation Oncology,
Utrecht, The Netherlands
Purpose or Objective
International guidelines as well as the GEC-ESTRO
recommendations and ICRU-89 report encourage
progression to more advanced techniques, while achieving
a uniform registration and reporting of radiotherapy. Do
we meet the present clinical standard in cervical cancer
radiotherapy? Therefore, supported by the Dutch National
Platform for Radiotherapy of Gynaecological Cancer
(LPRGT), we investigated the possible variation in current
practice for cervical cancer amongst the Dutch radiation
oncology centres specialised in gynaecological oncology.
Material and Methods
A structured patterns of care questionnaire was
completed during a face-to-face interview with radiation
oncologists from all sixteen radiotherapy centres in the
Netherlands specialised in gynaecological oncology. The
survey addressed important factors that might influence
treatment outcome after external beam radiotherapy
(EBRT) and brachytherapy (BT): the definition of target
volumes, treatment preparation, imaging for treatment
planning, treatment planning and IGART for EBRT and BT.
Results
All Dutch centres follow and meet the recommendations
from the (inter)national guidelines. Within the freedom of
the guidelines, we found differences between centres that
may have a clinical impact, among others: differences in
fractionation size and total dose (with an EQD2 for normal
tissue after EBRT varying between 43 and 50 Gy), when or
whether to use PET-CT imaging depending on availability
of equipment, if para-aortic lymph nodes should be
included in the CTV or not, and which technique is used to
reduce the dose in OARs (i.e. whether to use box-fields,
arc-rotation therapy, IMRT or IGART with a plan of the day
strategies), if and when interstitial needles where used for
BT, and whether brachytherapy was guided by CT or MRI.
Conclusion
Most differences in radiation practice for cervical cancer
are found at the cutting edge of clinical evidence. The
majority of these uncertainties are being addressed in
current and future (inter)national studies. For instance, to
improve uniformity, the LPRGT organized workshops for
all Dutch gynaecologic radiation oncologist, who are
encouraged to uniformly treat patients and report
outcome within the international EMBRACE II study.
PO-0709 Disease courses in women with residual
tumor after concurrent chemoradiotherapy for
cervical cancer
Y.S. Kim
1
, S. Byun
1
, J. Nam
2
1
Asan Medical Center- Univ of Ulsan, Radiation Oncology
Department, Seoul, Korea Republic of
2
Asan Medical Center- Univ of Ulsan, Obstetrics and
Gynecology, Seoul, Korea Republic of
Purpose or Objective
To investigate the disease course and identify prognostic
factors for survival in patients with residual disease
according to post-treatment magnetic resonance imaging
(MRI) following definitive concurrent chemoradiotherapy
(CCRT) for locally advanced cervical cancer.
Material and Methods
We reviewed clinical data from the medical records of 545
consecutive women with biopsy-proven, International
Federation of Gynecology and Obstetrics stage IB2–IVA
uterine cervical cancer treated with CCRT. Post-