ESTRO 36 Abstract Book

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S687 ESTRO 36 2017
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RECIST ver 1.1. Acute toxicity was assessed based on
CTCAE 4.0 and RTOG grading of Acute toxicities.
Results
Patients who tolerated treatment well without acute
radiation or chemotherapy induced morbidity were
comparable in both arms (62.06%(A) and 27.7%(B)) and
(55.17(A)% 18.1%(B)) respectively. Grade I/II proctitis was
seen in 5 patients(17.2%) in Arm A and 4 patients in Arm
B(13.7%) Diarrhea requiring medication (Grade II) was seen
only in 1 patient conventional group. None of the patients
in the concomitant boost group had Genitourinary
morbidity while 1 patient developed GU morbidity in the
conventional group. Development of Gr I Skin reaction was
comparable in both groups. The local control rates were
72.4% vs 51.7% in favor of the control group.
Conclusion
The use of concomitant boost in the management of
locally advanced cervical cancers is not widely practiced
due to the general perception that the toxicity profile may
be more due to dose escalation. This study shows that the
acute toxicity profile of concomitant boost using
conformal therapy is comparable to that of conventional
fractionated radiotherapy with better local control rates.
Further randomized studies need to be carried out to
assess the long term outcome of concomitant boost in
locally advanced cervical cancer.
EP-1292 Prognostic factors of patients with cancer of
uterine cervix in chemo-irradiation era.
F. James1, A. Kumar1, S. Mathews1, J. Joseph1, P.S.
George2 , A. Mathew2m M. Anjanappa (India)
1 Regional Cancer Centre- Trivandrum, Radiation
Oncology, Trivandrum, India
2 Regional Cancer Centre- Trivandrum, Biostatistics and
Epidemiology, Trivandrum, India
Purpose or Objective
Cancer cervix is the second commonest female cancer in
India and accounts for 20.2% cancer mortality in women.
Majority of the patients present with advanced stage in
our centre. The study aims to identify factors affecting the
outcome of cancer cervix treated in Chemo-irradiation
era.
Material and Methods
From a surveillance study of 1046 cervical cancer patients
treated at our centre, between January 2006 to
December 2008, data of 790 patients who had radical
radiotherapy were taken . Known prognostic factors like
stage, age , histological type, use of chemotherapy and
overall duration of treatment were taken for the study.
The survival rate was analysed using the Kaplan-Meier
method. Survival data between groups were compared
with the Log-rank test for univariate analysis and Cox
regression analysis for multivariate analysis.
Results
For the 790 patients, median age was 54.9 years (28-82)
with standard deviation(SD) of 10. Median follow up was
59 months (4-93) with SD of 20.5.The five year survival
probability is 70.3%.The probability of five year survival
is 81.2%,80.1%,57.1%,26.7% for stage 1,2,3 and 4
respectively. For patients younger than 40 , 40-70 and
older than 70 years, the probability of five year survival
are 68%,71.6% and 52.7% respectively. Patients who
had squamous cell carcinoma did better with 72% than
those with adeno carcinoma with 59.2% survival
probability. The patients who had concurrent
chemotherapy (two third of patients) also did better
(74.2% compared to 62.3%).Regarding overall treatment
time , <8,<9 and <10 weeks were tested. The survival
probability decreased significantly when
the treatment extended to 9 weeks or more (76.1% vs
63.9%). This remained
significant whether chemotherapy was used or not.
In univariate analysis, stage, age, histological subtype, use
of chemotherapy and treatment duration less than 9
weeks were significant predictors of survival. In the
multivariate analysis, earlier stage of disease ( stage 2 or
less ) , use of chemotherapy, and duration
of treatment less than 9 weeks were significant.
Conclusion
For patients receiving radical radiation for cancer cervix ,
stage, concurrent chemotherapy and finishing treatment
within 9 weeks are significant factors for survival.
EP-1293 Clinical outcome of prophylactic PAN
irradiation for locally advanced cervical cancer
K. Fukuda1, Y. Nishimura1, K. Nakamatsu 1
1Kindai University Faculty of Medicine, radiation
oncology, Osaka-Sayama, Japan
Purpose or Objective
The aim of this study is to analyze the outcomes of
curative irradiation for locally advanced cervical cancer
with or without prophylactic irradiation for para-aortic
lymph nodes (PAN).
Material and Methods
Between 1999 and 2015, 70 patients with locally advanced
cervical cancer treated with curative radiation therapy
were analyzed. The median age was 61 years old. From
1999 to 2008, 33 patients were performed prophylactic
irradiation for PAN after the treatment of whole pelvic
region (PAN+ group). For PAN area, all patients were
treated with 2-4 beams using 10-MV X-ray to a total dose
of 45Gy /25fr or 50.4Gy /28fr. After 2008, prophylactic
irradiation was not performed for 37 patients (PAN-group).
Of 70 patients, 44 patients were performed concurrent
chemo therapy. All patients were classified according to
FIGO staging system. Our cohort includes 47 patients of
stage 3 and 23 patients of stage 4. The acute and late
complications were evaluated according to CTCAE ver.
4.0.
Results
For all patients, 5-year overall survival rate was 53%. For
PAN+ group and PAN- group, relapse from PAN area were
observed for 3 patients each (9%, 8%). There was no
difference between two groups. An acute gastro-intestinal
toxicity more than grade 2 were observed in 6 patients
from PAN+ group and 1 patient from PAN- group. A late
gastro-intestinal toxicity more than grade 2 was observed
in 5 patients and 4 patients from PAN+ group and from
PAN- group respectively.
Conclusion
Prophylactic irradiation for PAN did not prevent local
recurrence from PAN area.
EP-1294 Interfractional motion of vaginal cuff after
hysterectomy in gynecologic cancer
S. Chun 1, K.Y. Eom2, H. Kim3
1SNUH, Radiation Oncology, SEOUL, Korea Republic of
2Bundang Hospital- Seongnam- Korea, Radiation
Oncology, Seongnam, Korea Republic of
3Soonchunhyang University Hospital, Department of
Radiation Oncology/Cyberknife center, Seoul, Korea
Republic of
Purpose or Objective
To identify relationship between bladder and rectal
volume changes during radiotherapy with vaginal stump
movement. Also by calculating vaginal stump movement,
adequate PTV margin for vaginal stump can be
determined.
Material and Methods
Ten patients with cervical or endometrial cancer were
enrolled prospectively. All patients received surgery with
curative aim and adjuvant radiotherapy. Patients took
cone beam CT (CBCT) once a week with radiocontrast
soaked gauze and radiopaque markers to visualize vaginal
stump. Each patient underwent total 6 CT imaging
acquisition including one simulation CT and 5 CBCTs. All
CBCT images of each patient were transported to initial