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Application of Adaptive Radiation Therapy During External Radiation Therapy for Locally Advanced Cervical Cancer Reduce Acute Toxicities and Improve the Tolerance of the Patient During Radiation Therapy
E316
International Journal of Radiation Oncology Biology Physics
2751
patients received twice surveys at different time points. The QoL was evaluated by the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) and a four-item radiotherapy complication self-made scale consisted of brief four YeseNo questions in the side effects of GI and genitourinary. The QoL have been assessed and compared in seven different time stages (1, 2-6, 7-12, 13-18,19- 24, 25-30, 31-36 months) after RT. Data for tumor characteristics at diagnosis, treatment and disease progression were available. Multivariate analysis and logistic regression were performed to identify factors associated with QoL. Results: Our findings indicated that the QoL scores of patients with cervical cancer was gradually improved over time after RT. Multivariate analysis showed that the women with these factors: the shorter time after RT, diarrhea, constipation, lower urinary tract dysfunction, lower extremity lymphedema, marital status (Single or divorced), the lower family income , asexual life and without health insurance had significantly worse QoL (P<0.05). The multivariate analysis of different stages showed that intestinal dysfunction, lower urinary tract dysfunction, marital status and sexual life were independent factors those have affected the QoL at least three time periods. Conclusion: The overall trend of QoL of cervical cancer survivors was gradually improved over time after RT. Late gastrointestinal and genitourinary toxicity after RT had significant negative impact on the QoL of patients, So more attention should be focused on how to prevent and treat the long-term toxicities of RT. Author Disclosure: Z. Yin: None. H. Wu: None. L. Li: None. J. Ni: None. M. Chen: None. H. Lou: None.
Application of Adaptive Radiation Therapy During External Radiation Therapy for Locally Advanced Cervical Cancer Reduce Acute Toxicities and Improve the Tolerance of the Patient During Radiation Therapy J. Yin,1 J. Lang,2 M. Feng,3 and Z. Fan2; 1Sichuan Cancer Hospital & Institute, Chengdu, China, 2Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 3Radiation oncology department, Sichuan Cancer Hospital and Institution, Chengdu, China Purpose/Objective(s): To compare clinical effect,toxicities and side effect differences in different external radiotherapy modes for locally advanced cervical cancer, which adopt strategy of singe off-line adaptive intensity modulated radiotherapy or the strategy of single-course intensity modulated radiotherapy. Materials/Methods: Total of 112 locally advanced cervical cancer cases (Stage IIB-IVA) who received concurrent radiochemotherapy in our hospital from 2010 to 2015 were enrolled and divided into two groups:A.the single-course radiotherapy group (nZ62), whose radiotherapy plan remained unchanged during the whole course of external radiotherapy, B:the single off-line adaptive radiotherapy group (ART Group; nZ50), who received 15 external radiation (27Gy) according to original plan (Plan1), were rescanned then for the design of off-line adaptive plan (Plan2). All received 45-50.4Gy/25-28f for both groups followed by 3DICBT; Cis-platinum was the basic medication for synchronized chemotherapy regimens. Patients were followed up during the therapy and outpatient reexaminations. Survival rates as well as differences of acute and chronic toxic and side effect occurrence rate were compared between the two groups. Results: Average GTV volume was decreased for from （107.6732.02） cm3 before treatment to （63.2125.78）cm3 after 15times of irradiation (p˂0.05);Changes of rectum, bladder and small intestine volumes showed no statistical difference between two plans. It was indicated by survival analysis that the 3-year OS and PFS of B and A group(95.2% and 93.3%.p>0.05) and(90.9% and 80.4%,p>0.05) were no statistical difference; Occurrence rate of acute diarrhea in the A group was significantly higher than the B Group (48.39% and 30%, pZ0.046). While occurrence rates of other chronic and acute toxic and side effects showed no significant differences between the two groups. Conclusion: The Implementation of ART in locally advanced cervical cancer showed no significant difference on 3-year OS and PFS compared with single-course intensity-modulated radiation therapy. But ART might reduce occurrence of some acute toxicities of radiotherapy such as diarrhea and improved patient’s tolerance during treatments. Author Disclosure: J. Yin: None. J. Lang: None. M. Feng: None. Z. Fan: None.
2752 A Prospective Survey on Quality of Life Among Chinese Cervical Cancer Survivors at Different Time Stages after Radiation Therapy Z. Yin, H. Wu, L. Li, J. Ni, M. Chen, and H. Lou; Zhejiang Cancer Hospital, Hangzhou, China Purpose/Objective(s): Radiotherapy (RT) for cervical cancer carries a risk of gastrointestinal (GI) and genitourinary toxicity, which might adversely affect the quality of life (QoL). There is a paucity of data on treatment factors for long-term QoL. The purpose of this study was to assess the QoL of cervical cancer survivors in the different time periods within 3 years after RT. Materials/Methods: A prospective study was conducted among 1610 cervical cancer patients who received radical RT or postoperative RT with or without concurrent chemotherapy in 2010-2013 at the Zhejiang Cancer Hospital in China. The survey started from Jan 2013 to the end of Dec 2014. A total of 1876 valid questionnaires were received, 266
2753 Recurrence Patterns in Patients with UterusConfined Endometrial Cancer S. Yuce Sari,1 M. Gultekin,2 K. Yuce,2 T. Gungor,3 G. Tulunay,4 A. Ayhan,5 and F. Yildiz2; 1Hacettepe University Medical Faculty, Ankara, Turkey, 2Hacettepe University Medical School, Ankara, Turkey, 3Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey, 4Etlik Zu¨beyde Hanım Women’s Disease Training and Research Hospital, Ankara, Turkey, 5Baskent University Medical School, Ankara, Turkey Purpose/Objective(s): To evaluate recurrence patterns in uterus-confined endometrial cancer that received external radiotherapy (ERT) and/or brachytherapy (BRT) after complete staging surgery. Materials/Methods: We retrospectively evaluated 270 patients with uterus-confined endometrial cancer that received ERT and/or BRT, depending on the pathological risk factors, between 1994 and 2013 after complete staging surgery. Patients were grouped to have intermediate risk (group 1), high-intermediate risk (group 2), and high risk (group 3) according to the ESMO-ESGO-ESTRO consensus guideline, and their survival rates and recurrence patterns were evaluated. Results: Median follow-up was 74 months (range: 2-243 months). Median age of the patients were 58 years (range: 31-87 years). The number of patients in group 1, 2, and 3 were 98 (36%), 68 (25%), and 104 (39%), respectively. When the groups were compared according to tumor and treatment characteristics, age (60 years vs. >60 years), and the type of lymph node (LN) dissection (pelvic vs. pelvic+para-aortic) were similar among the three groups. However, tumor size, the number of dissected LNs, and number of patients that received ERT were significantly higher in group 3 (Table 1). The rate of loco-regional recurrence (LRR) was similar between the groups. However, the rate of distant metastasis (DM) was significantly higher in group 3. The rates of overall survival, disease-free survival, and DM-free survival were not different between the groups. However, the rate of LRR-free survival was the highest in group 1 but similar in groups 2 and 3. Conclusion: The rate of loco-regional control is high and DM is rare in patients with uterus-confined endometrial cancer after adjuvant RT. However, the risk of DM is higher in patients with high-risk disease. Chemotherapy can be considered in these patients.
International Journal of Radiation Oncology Biology Physics
2751
patients received twice surveys at different time points. The QoL was evaluated by the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) and a four-item radiotherapy complication self-made scale consisted of brief four YeseNo questions in the side effects of GI and genitourinary. The QoL have been assessed and compared in seven different time stages (1, 2-6, 7-12, 13-18,19- 24, 25-30, 31-36 months) after RT. Data for tumor characteristics at diagnosis, treatment and disease progression were available. Multivariate analysis and logistic regression were performed to identify factors associated with QoL. Results: Our findings indicated that the QoL scores of patients with cervical cancer was gradually improved over time after RT. Multivariate analysis showed that the women with these factors: the shorter time after RT, diarrhea, constipation, lower urinary tract dysfunction, lower extremity lymphedema, marital status (Single or divorced), the lower family income , asexual life and without health insurance had significantly worse QoL (P<0.05). The multivariate analysis of different stages showed that intestinal dysfunction, lower urinary tract dysfunction, marital status and sexual life were independent factors those have affected the QoL at least three time periods. Conclusion: The overall trend of QoL of cervical cancer survivors was gradually improved over time after RT. Late gastrointestinal and genitourinary toxicity after RT had significant negative impact on the QoL of patients, So more attention should be focused on how to prevent and treat the long-term toxicities of RT. Author Disclosure: Z. Yin: None. H. Wu: None. L. Li: None. J. Ni: None. M. Chen: None. H. Lou: None.
Application of Adaptive Radiation Therapy During External Radiation Therapy for Locally Advanced Cervical Cancer Reduce Acute Toxicities and Improve the Tolerance of the Patient During Radiation Therapy J. Yin,1 J. Lang,2 M. Feng,3 and Z. Fan2; 1Sichuan Cancer Hospital & Institute, Chengdu, China, 2Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 3Radiation oncology department, Sichuan Cancer Hospital and Institution, Chengdu, China Purpose/Objective(s): To compare clinical effect,toxicities and side effect differences in different external radiotherapy modes for locally advanced cervical cancer, which adopt strategy of singe off-line adaptive intensity modulated radiotherapy or the strategy of single-course intensity modulated radiotherapy. Materials/Methods: Total of 112 locally advanced cervical cancer cases (Stage IIB-IVA) who received concurrent radiochemotherapy in our hospital from 2010 to 2015 were enrolled and divided into two groups:A.the single-course radiotherapy group (nZ62), whose radiotherapy plan remained unchanged during the whole course of external radiotherapy, B:the single off-line adaptive radiotherapy group (ART Group; nZ50), who received 15 external radiation (27Gy) according to original plan (Plan1), were rescanned then for the design of off-line adaptive plan (Plan2). All received 45-50.4Gy/25-28f for both groups followed by 3DICBT; Cis-platinum was the basic medication for synchronized chemotherapy regimens. Patients were followed up during the therapy and outpatient reexaminations. Survival rates as well as differences of acute and chronic toxic and side effect occurrence rate were compared between the two groups. Results: Average GTV volume was decreased for from （107.6732.02） cm3 before treatment to （63.2125.78）cm3 after 15times of irradiation (p˂0.05);Changes of rectum, bladder and small intestine volumes showed no statistical difference between two plans. It was indicated by survival analysis that the 3-year OS and PFS of B and A group(95.2% and 93.3%.p>0.05) and(90.9% and 80.4%,p>0.05) were no statistical difference; Occurrence rate of acute diarrhea in the A group was significantly higher than the B Group (48.39% and 30%, pZ0.046). While occurrence rates of other chronic and acute toxic and side effects showed no significant differences between the two groups. Conclusion: The Implementation of ART in locally advanced cervical cancer showed no significant difference on 3-year OS and PFS compared with single-course intensity-modulated radiation therapy. But ART might reduce occurrence of some acute toxicities of radiotherapy such as diarrhea and improved patient’s tolerance during treatments. Author Disclosure: J. Yin: None. J. Lang: None. M. Feng: None. Z. Fan: None.
2752 A Prospective Survey on Quality of Life Among Chinese Cervical Cancer Survivors at Different Time Stages after Radiation Therapy Z. Yin, H. Wu, L. Li, J. Ni, M. Chen, and H. Lou; Zhejiang Cancer Hospital, Hangzhou, China Purpose/Objective(s): Radiotherapy (RT) for cervical cancer carries a risk of gastrointestinal (GI) and genitourinary toxicity, which might adversely affect the quality of life (QoL). There is a paucity of data on treatment factors for long-term QoL. The purpose of this study was to assess the QoL of cervical cancer survivors in the different time periods within 3 years after RT. Materials/Methods: A prospective study was conducted among 1610 cervical cancer patients who received radical RT or postoperative RT with or without concurrent chemotherapy in 2010-2013 at the Zhejiang Cancer Hospital in China. The survey started from Jan 2013 to the end of Dec 2014. A total of 1876 valid questionnaires were received, 266
2753 Recurrence Patterns in Patients with UterusConfined Endometrial Cancer S. Yuce Sari,1 M. Gultekin,2 K. Yuce,2 T. Gungor,3 G. Tulunay,4 A. Ayhan,5 and F. Yildiz2; 1Hacettepe University Medical Faculty, Ankara, Turkey, 2Hacettepe University Medical School, Ankara, Turkey, 3Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey, 4Etlik Zu¨beyde Hanım Women’s Disease Training and Research Hospital, Ankara, Turkey, 5Baskent University Medical School, Ankara, Turkey Purpose/Objective(s): To evaluate recurrence patterns in uterus-confined endometrial cancer that received external radiotherapy (ERT) and/or brachytherapy (BRT) after complete staging surgery. Materials/Methods: We retrospectively evaluated 270 patients with uterus-confined endometrial cancer that received ERT and/or BRT, depending on the pathological risk factors, between 1994 and 2013 after complete staging surgery. Patients were grouped to have intermediate risk (group 1), high-intermediate risk (group 2), and high risk (group 3) according to the ESMO-ESGO-ESTRO consensus guideline, and their survival rates and recurrence patterns were evaluated. Results: Median follow-up was 74 months (range: 2-243 months). Median age of the patients were 58 years (range: 31-87 years). The number of patients in group 1, 2, and 3 were 98 (36%), 68 (25%), and 104 (39%), respectively. When the groups were compared according to tumor and treatment characteristics, age (60 years vs. >60 years), and the type of lymph node (LN) dissection (pelvic vs. pelvic+para-aortic) were similar among the three groups. However, tumor size, the number of dissected LNs, and number of patients that received ERT were significantly higher in group 3 (Table 1). The rate of loco-regional recurrence (LRR) was similar between the groups. However, the rate of distant metastasis (DM) was significantly higher in group 3. The rates of overall survival, disease-free survival, and DM-free survival were not different between the groups. However, the rate of LRR-free survival was the highest in group 1 but similar in groups 2 and 3. Conclusion: The rate of loco-regional control is high and DM is rare in patients with uterus-confined endometrial cancer after adjuvant RT. However, the risk of DM is higher in patients with high-risk disease. Chemotherapy can be considered in these patients.