ESTRO 36 Abstract Book
S25 ESTRO 36 2017 _______________________________________________________________________________________________
8 Aarhus University Hospital, Department of Oncology, Aarhus, Denmark Purpose or Objective To report patterns of local failure (LF) after radiochemotherapy and MR-image-guided adaptive brachytherapy (IGABT) in patients with loc ally advanced cervical cancer (LACC) observed within the international prospective observational multicenter study „EMBRACE“ (An international study on MRI-guided brachytherapy in locally advanced cervical cancer, www.embracestudy.dk ). Material and Methods From 2008-2015, 1419 patients with LACC treated with radiochemotherapy and MR-IGABT (GEC-ESTRO recommendations) were included in the study. 1230 patients with completed treatment without major protocol violations (n=73) and with at least one follow up examination were available for this analysis (106 excluded). A LF was defined as incomplete remission in case of persistent disease 3 months after treatment which did not resolve at six months and as local recurrence after complete remission in case of recurrent disease. LFs were described based on their relation to (1) the clinical target volumes (CTV) and to (2) infiltrated organs / compartments. Results After a median follow-up of 25 months 80 local fai lures (24 incomplete remissions and 56 local recurrences) were observed. Synchronous nodal or distant metastases were reported in 42 patients (52%, not reported: 5%). Median time to local recurrence was 11.5 months, 47 (86%) occurred within 24 months. Information about the location of LF was available in 63 patients (79%): The cervix and uterus were involved in 50 patients (80%), the proximal parametria in 8 patients (13%), the distal parametria/pelvic wall in 18 patients (29%), the vagina in 18 patients (29%), the urinary bladder in 12 patients (19%) and the rectum in 2 patients (3%), respectively (more than one location possible). An allocation to CTV was possible in 53 patients (66%): In 51% the LF were located inside the high risk (HR) CTV (n=27), in 17% inside the intermediate (IR) CTV (n=9) and in 30% inside the HR+IR CTV (n=16). 2% was not related to the CTVs (n=1). Conclusion Local failures occur in a very limited number of patients after radiochemotherapy and IGABT. They are in about 50% synchronous with nodal or distant disease. The vast majority occurs within two years. Most patients fail locally within the HRCTV and IR CTV. OC-0056 Bowel morbidity in cervix cancer after RCHT+IGABT; physician and patient reported outcome - EMBRACE N.B.K. Jensen 1 , K. Kirchheiner 2 , L.U. Fokdal 1 , J.C. Lindegaard 1 , C. Kirisits 2 , R. Mazeron 3 , U. Mahantshetty 4 , B. Segedin 5 , I.M. Jürgenliemk-Schulz 6 , P.J. Hoskin 7 , R. Pötter 2 , K. Tanderup 1 1 Aarhus University Hospital, Department of Oncology, Aarhus C, Denmark 2 Medical university of Vienna / General Hospital of Vienna, Department of Radiation Oncology- Comprehensive Cancer Center, Vienna, Austria 3 Gustave-Roussy, Department of Radiotherapy, Villejuif, France 4 Tata Memorial Hospital, Department of Radiation Oncology, Mumbai, India 5 Institute of Oncology Ljubljana, Department of Radiotherapy, Ljubljana, Slovenia 6 University Medical Centre Utrecht, Department of Radiation Oncology, Utrecht, The Netherlands 7 Mount Vernon Hospital, Cancer Centre, London, United Kingdom
Conclusion Treatment had a profound impact on QoL. For some systems this was temporarily, other symptoms persisted during further follow-up. End of external beam treatment is the most sensitive time point to measure future improvements in online adaptive radiotherapy with a PotD approach. OC-0055 Local failures after radiochemotherapy and MR-image-guided brachytherapy in cervical cancer patients M. Schmid 1 , C. Haie-Meder 2 , U. Mahanshetty 3 , I.M. Jürgenliemk-Schulz 4 , B. Segedin 5 , P. Hoskin 6 , C. Kirisits 7 , J. Lindegaard 8 , K. Tanderup 8 , R. Pötter 7 1 Medizinische Universität Wien Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria 2 Gustave Roussy, Department of Radiotherapy, Paris, France 3 Tata Memorial Hospital, Department of Radiation Oncology, Mumbai, India 4 Utrecht University, Department of Radiation Oncology, Utrecht, The Netherlands 5 Institute of Oncology, Department of Oncology, Ljubiljana, Slovenia 6 Mount Vernon Cancer Center, Department of Radiotherapy, Northwood, United Kingdom 7 Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria
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