ESTRO 36 Abstract Book

705 / 1082

S689 ESTRO 36 2017
_______________________________________________________________________________________________
Africa. Hyperthermia is a known radiosensitiser used to
treat cervical cancer with improved clinical outcomes and
survivals. The aim of this study is to determine the clinical
effects of the addition of modulated electro-hyperthermia
to the standard treatment protocols for locally advanced
cervical cancer patients in state healthcare in South
Africa.late toxicity and 2 year survival.
Material and Methods
This ongoing phase III randomised clinical trial is being
conducted at the Charlotte Maxeke Johannesburg
Academic Hospital. The study aims to enrol 236 female
participants with FIGO stage IIB (initial distal parametrium
involvement) to IIIB cervical cancer (bilateral
hydronephrosis excluded). Participants are being
randomised into a 'Hyperthermia” group (electro-
hyperthermia plus chemoradiation) and a 'Control” group
(chemoradiation alone). Randomisation stratum: HIV
status, age and stage of disease. Participants in both
groups are receiving 25 fractions of 2Gy external beam
radiation, 3 doses of high dose rate brachytherapy (8Gy)
and up to 3 doses of cisplatin (80mg/m2). Two local mEHT
sessions are administered per week prior to radiotherapy
in the Hyperthermia group. Local disease control is
assessed by Positron Emission Tomography (PET) scans and
early toxicity is graded according to the CTCAE version 4.
Results
We report on the interim analysis on local disease control
and early toxicity of the first half of the recruited
participants in our study. Early results show an
improvement in local disease control with no unexpected
early toxicity in the hyperthermia group.
Conclusion
There is a positive trend in the Hyperthermia group
suggesting that the addition of hyperthermia may be
beneficial in locally advanced cervical cancer patients.
EP-1298 Radiotherapy in invasive vaginal carcinoma: a
systematic review
M. Buwenge1, G. Macchia2, M. Ferioli1, L. Giaccherini1, A.
Arcelli 1,3, A. Galuppi1, S. Cammelli1, A.M. Perrone4, P. De
Iaco 4, M. Boccardi2, L. Tagliaferri5, G. Ferrandina 6, F.
Deodato2 , S. Cilla7 , G.P. Frezza3, A.G. Morganti 1
1 University of Bologna, Radiation Oncology Center-
Department of Experimental- Diagnostic and Speciality
Medicine - DIMES, Bologna, Italy
2 Fondazione di Ricerca e Cura "Giovanni Paolo II",
Radiotherapy unit, Campobasso, Italy
3 Ospedale Bellaria, Radiotherpy Department, Bologna,
Italy
4 Sant'Orsola-Malpighi Hospital, Gynecologic Oncology
Unit, Bologna, Italy
5 Policlinico Universitario "A.Gemelli"- Università
Cattolica del Sacro Cuore, Department of Radiotherapy,
Rome, Italy
6 Policlinico Universitario "A. Gemelli"- Università
Cattolica del Sacro Cuore, Gynecologic Oncology Unit,
Rome, Italy
7 Fondazione di Ricerca e Cura "Giovanni Paolo II",
Medical Physics Unit, Campobasso, Italy
Purpose or Objective
Primary vaginal carcinoma (VC) is rare, accounting for 1-2
% of all gynaecological malignancies. Being rare, most
studies are retrospective and few trials are available in
literature based on modern radiotherapy (RT) treatments.
Therefore, aim of this analysis was to systematically
review the recent literature on RT in VC to better define
its role.
Material and Methods
From Pubmed database, a literature search strategy was
performed using the PRISMA guidelines including published
prospective and retrospective trials on either form of RT
in invasive VC published between 2000 and 2016.
Editorials, letters and case reports were excluded.
Results
Recorded data were number of patients, period of
enrolment, median follow up, treatment characteristics
and treatment outcomes. A total of 548 patients (median
age 65 years) from 10 studies were analyzed based on
selection criteria. Most studies were small retrospective
series on patients treated between 1959 and 2014 with
different methods in terms of dose, fractionation,
treatment techniques, previous surgery, concurrent
chemotherapy, combination with brachytherapy (BT), and
evaluation modalities. Concurrent chemotherapy was used
in 4 studies and 3 papers included postoperative RT. In
most studies (8) external beam RT plus BT boost was used.
Various RT techniques were used in 6 studies (AP/PA, box-
technique, IMRT, VMAT), while in 4 studies the technique
was not reported. In only 3 studies IMRT (2) or VMAT(1)
were used. Acute and late grade ≥ 3 toxicities ranges were
2.4-17.0% and 2.4-17.8%, respectively. Median 5-year DFS
was 77.3% (I-II stage; 25.0-92.4%, III-IV stage; 0.0-48.5%).
Median 5-year OS was 58.4% (I- II stage; 25.2-83.7%, III-IV
stage; 0.0-50.5%) with significant impact of stage on
patients outcome.
Conclusion
Only few studies have been published in the last decade
with large heterogeneity in terms of treatment
characteristic and evaluation criteria. Clinical results
were strongly influenced by tumor stage. Prospective
studies based on advanced RT techniques are needed to
better define the role of modern RT in these patients and
to improve outcome in advanced stages of VC.
EP-1299 Nomogram prediction for overall survival of
patients diagnosed with cervical cancer.
S. Jagadeesan1
1Kidwai memorial institute of oncology, radiation
oncology, Bangalore- Karnataka, India
Purpose or Objective
Nomograms are predictive tools that are widely used for
estimating cancer prognosis. The aim of this study was to
develop a nomogram for the prediction of overall survival
(OS) in patients diagnosed with cervical cancer.
Material and Methods
Cervical cancer databases of our institutie were analysed.
Overall survival was defined as the clinical endpoint and
OS probabilities were estimated using the Kaplan-Meier
method. Based on the results of survival analyses and
previous studies, relevant covariates were identified, a
nomogram was constructed and validated using bootstrap
cross-validation. Discrimination of the nomogram was
quantified with the concordance probability.
Results
In total, 42 consecutive patients with invasive cervical
cancer, who had all nomogram variables available, were
identified. Mean 5-year OS rates for patients with
International Federation of Gynecologists and
Obstetricians (FIGO) stage IA, IB, II, III, and IV were 99.0%,
88.6%, 65.8%, 58.7%, and 41.5%, respectively. two cancer-
related deaths were observed during the follow-up period.
FIGO stage, tumour size,tumour type histologic subtype,
ph, parametrial involvement, endometrial invasion and
organ involvement were selected as nomogram
covariates. In our study, the total bad prognostic score
mean value is 12. So, we derived more than 12 as high risk,
more than 10-12 as intermediate risk and; less than 10 as
low risk group. Based on predictor Lin‘s statistic
concordance index value is 0.61. The normal value of C
index is ±1. In our study we had achieved perfect
concordance index value which is suggestive of perfect
normogram.
Conclusion
Based on eight easily available parameters, a novel
statistical model to predict OS of patients diagnosed with
cervical cancer was constructed and validated. The model
was implemented in a nomogram and provides accurate
prediction of individual patients' prognosis useful for