980 / 1082
S964
ESTRO 36 2017
_______________________________________________________________________________________________
3.6 Gy, 5.3 Gy and 4.6 Gy (p=0.045), respectively. Needle
number showed inverse correlation with D2(r) (p=0.0264)
and D1(r) (p=0.0433) parameters. Volume of HR-CTV
correlated with D2(r) (r
2
=0.58) and D2(s) (r
2
=0.71).
Conclusion
Dosimetric results of combined intracavitary-interstitial
IGABT were comparable to international literature.
Dosimetric quality of these plans was significantly higher
than intracavitary 2D and 3D optimized plans. Although 3D
optimisation improved the quality of conventional 2D
plans, IGABT plans resulted in even more homogeneous
dose distribution and significantly lower doses to organs at
risks.
EP-1779 High-dose rate brachytherapy for inoperable
endometrial cancer: definitive results
L. Draghini
1
, F. Trippa
2
, M. Casale
2
, P. Anselmo
1
, F.
Arcidiacono
1
, S. Fabiani
1
, M. Italiani
1
, E. Maranzano
1
1
Radiation Oncology Centre "S.Maria" Hospital Terni,
Oncology Departement, Terni, Italy
2
Radiation Oncology Centre- “S.Maria” Hospital Terni,
Oncology Department, Terni, Italy
Purpose or Objective
Purpose/Objective:
To report our experience on three
dimensional (3D) high-dose rate brachytherapy (HDR-BRT)
in patients with stage I-III inoperable endometrial cancer.
Material and Methods
Material/Methods:
Between March 2005 and April 2016 17
patients underwent HDR-BRT or HDR-BRT after external
beam radiotherapy (EBRT) as definitive treatment. Median
age was 79 years (range, 60-95), median KPS 90% (range,
60-100). Histology was endometrial adenocarcinoma in 14
(82%) and non-endometrial in 3 (18%) patients. In 15 (88%)
patients FIGO clinical stage was I and in remaining 2 (12%)
III. All patients were evaluated with computed
tomography (CT) and endometrial biopsy, in 2 cases also
magnetic resonance imaging (MRI) was done. Using the
Fletcher applicator, a CT-based planning HDR-BRT was
delivered. Follow-up was performed with physical
examination, cervical cytology and CT or MRI. Local
control (LC) was obtained when there was an interruption
of vaginal bleeding.
Results
Results:
All patients had a clinical LC, table 1 shows dose
schedules used. After a median follow-up of 36 months
(range, 6-131), 3 and 6 years LC rates were 86% and 69%,
respectively. Cancer specific survival (CSS) at 1, 2 and 6
years was 93%, 85%, 85%, respectively. Age, stage, dose
and type of radiotherapy did not result significant
prognostic factors for LC and CSS. Only histology
significantly influenced LC: for high risk histology (i.e.,
non-endometrial carcinoma or grade (G)3 endometrial
adenocarcinoma) LC was 73% at 1 year and 36% at 6 years,
for low risk histology (i.e. G1-2 endometrial
adenocarcinoma) was 100% at 1 and 6 years (p=0.05).
Acute toxicity was registered in 2 (12%) patients: G2
nausea and G2 proctitis in 1 patient (6%), G2 diarrhea, G2
anemia and G2 proctitis in 1(6%) patient. Two patients
(12%) had G1 late rectal bleeding.
Conclusion
Conclusion:
Our data show a good LC particularly in
patients with stage I low risk histology endometrial
cancer. Though number of patients is limited, definitive
HDR-BRT could be an alternative treatment option for
inoperable elderly patients with good compliance and
limited toxicity. Histology is a prognostic factor for LC.
Table 1. Dose schedules
HDR-BRT = high-dose rate brachytherapy
EQD2: Equivalent dose of 2 Gy per fraction calculated
using the equation EQD2 =
([d+ α/β]/[2Gy+α/β]) derived
from linear quadratic model.
Legend: * patients submitted to external beam
radiotherapy and brachytherapy
EP-1780 Postoperative endometrium: 68Gy
EQD2(α/β=3) at 2cc of vagina is related to G2 late
toxicity.
A. Rovirosa
1
, M. Aguilera
2
, C. Ascaso
3
, A. Herreros
4
, J.
Sánchez
5
, J. Garcia-Miguel
6
, S. Sabater
7
, G. Oses
8
, P.
Makiya
9
, S. Cortes
10
, J. Solà
6
, E. Agusti
11
, A. Huguet
6
, A.
Garrido
6
, A. Lloret
6
, C. Baltrons
6
, M. Arenas
12
1
Hospital Clinic Universitari, Radiation Oncology Dpt.,
Barcelona, Spain
2
Hospital Universitario de Caracas, Radiation Oncology
Dpt, Caracas, Venezuela
3
Faculty of Medicine- Universitat de Barcelona, Clinical
Basics Dpt, Barcelona, Spain
4
Hospital Clínic, Radiation Oncology Dpt., Barcelona,
Spain
5
Hospital Clinic Universitari, Finance Dpt, Barcelona,
Spain
6
Hospital Clínic Universitari, Radiation Oncology Dpt,
Barcelona, Spain
7
Hospital General de Alicante, Radaition Oncology Dpt,
Barcelona, Spain
8
Hospital Clínic Universitari, Radiation Oncology,
Barcelona, Spain
9
Hospital Rebagliati, Radiation Oncology Dpt., Lima,
Peru
10
Hospital Clínic Universitari, Radiation Oncolgy,
Barcelona, Spain
11
Hospital Clínic Universitari, Radiation Oncology Dpt,
Barclona, Spain
12
Hospital Sant Joan de Reus, Radiation Oncology Dpt,
Reus, Spain