700 / 1082
S684
ESTRO 36 2017
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Leukocytosis and neutrophilia were defined as a leukocyte
count or a neutrophils count exceeding 10,000 and
7,500/µl, respectively.
Results
113 patients were identified. All patients received a pelvic
irradiation concomitant with chemotherapy, extended to
the para-aortic area in 13 patients with IVB disease.
Neutrophilia and leukocytosis were significant univariate
prognostic factors for poorer local failure-free survival (p
= 0.000 and p = 0.002, respectively), associated with
tumor size, high-risk clinical target volume (HR-CTV) and
anemia. No effect was shown for distant metastases but
leukocytosis and neutrophila were both poor prognostic
factors for in-field relapses (p = 0.003 and p < 0.001). In
multivariate analysis, HR-CTV volume (p = 0.026) and
neutrophils count > 7,500/µl (p = 0.018) were independent
factors for poorer survival without local failure, with
hazard ratio (HR) of 3.1.
Conclusion
Neutrophilia is a significant prognostic factor for local
relapse in locally advanced cervical cancer treated with
MRI-based IGABT. This biomarker could help identifying
patients with higher risk of local relapse and requiring
dose escalation.
EP-1286 MRI vs clinical assessment in staging and
prediction of recurrence in carcinoma cervix treatment
A. Mintu Mathew
1
, S. Aravindh Anand
1
1
Goverment Medical College Trivandrum, Radiotherapy,
Trivandrum, India
Purpose or Objective
This prospective study aimed to evaluate the correlation
between MRI and clinical assessment in staging and
response evaluation of locally advanced carcinoma cervix.
It also aimed to assess the role of MRI as a predictor of
recurrence free survival.
Material and Methods
58 women with locally advanced carcinoma cervix were
studied from January 2014 to October 2015 after obtaining
informed consent. After MRI abdomen & pelvis ,patients
were started on chemo-radiation. Pelvic External beam
radiation (EBRT) to a dose of 45Gy/23 fractions with
concurrent weekly cisplatin 40mg/m2 was given, followed
by intracavitary brachytherapy 7Gy/fraction x 3 fractions
weekly once. Treatment response was assessed as per
RECIST criteria clinically and radiologically with MRI after
4-6 months. Both pre and post treatment radiological
evaluation was done by independent radiologists. Any
suspected recurrence was subjected to MRI assessment
and biopsy for proof.
Results
At a median follow up of 12 months, Kaplan Meir survival
analysis showed a recurrence free survival of 69.6%. The
hazard ratio of recurrence was 8.667 times between non-
responders and responders by MRI (p=0.001. 95% CI 2.82 to
35.1)and 1.667 between non responders and responders by
clinical assesment
(p=0.438).
Kaplan Meir analysis for recurrence free survival
separately done for patients who had achieved complete
response (on MRI) vs. those who did not, showed only
10.7% percent of the responders and 50 % of the non-
responders had recurrence. When assessing the clinical
response , it was seen that the 27.9% of the responders
and 38.5 % of the non-responders had recurrence showing
MRI was more useful in predicting recurrences.
The kappa analysis showed a value of 0.18 for initial
staging and 0.08 for response evaluation was which
signified poor agreement between MRI and clinical
assessment in both staging and response evaluation.
Bland-Altman analysis revealed a mean difference of
agreement of 0.28 (0 being complete agreement) between
MRI and clinical response evaluation [p= 0.002]
.
Conclusion
There are significant differences both in staging and
response evaluation between FIGO and MRI in carcinoma
cervix. In assessment of response to the standard
treatment, MRI was found to be a better predictor of
recurrence and thus ultimately, the outcome of treatment
.This study proves that MRI may be used as a tool in
assessment of treatment response thus predicting patients
who may go for treatment failure, and may benefit from
close follow up and early salvage.
EP-1287 10-Year outcomes on patients receiving
radical radiotherapy for cervicalv cancer
K. Woo
1
, L. Davis
2
, M. Light
3
, L. Croydon
4
, M. Powell
5
1
University College London Hospital, Oncology, London,
United Kingdom
2
Kings College Hospital, Oncology, London, United
Kingdom
3
Guys and St Thomas Hospital, Oncology, London, United
Kingdom
4
Institute of Cancer Research, Oncology, London, United
Kingdom
5
St Bartholomew's Hospital, Radiotherapy, London,
United Kingdom
Purpose or Objective
Cervical cancer is the second most common cancer in
women worldwide, 80% of which is treated primarily with
radiotherapy. Aim: To evaluate the outcome of patients
with cervical cancer treated with radical radiotherapy
either as primary treatment or given adjuvantly (+/-
chemotherapy) at single cancer centre between 1999 and
2009 in terms of overall survival (OS), acute and late