ESTRO 2022

Session Item

Gynaecological

Session Code: 6014

Session Type: Poster (digital)

Track: Clinical

WHICH IS THE BEST TIME TO ASSESS COMPLETE RESPONSE AFTER CHEMORADIATION IN ADVANCED CERVICAL CANCER?

ROSA AUTORINO, Italy

Presentation Number: PO-1347

Abstract

Abstract Title:

WHICH IS THE BEST TIME TO ASSESS COMPLETE RESPONSE AFTER CHEMORADIATION IN ADVANCED CERVICAL CANCER?

Authors:

ROSA AUTORINO¹, Valentina Lancellotta¹, Maura Campitelli¹, Alessia Nardangeli¹, Luca Russo², Raffaella Michela Rinaldi¹, Niccolò Bizzarri³, Benedetta Gui², Vittoria Rufini², Maria Gabriella Ferrandina⁴, Gabriella Macchia⁵, Maria Antonietta Gambacorta¹, Vincenzo Valentini¹

¹UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy; ²Radiology, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy; ³Gynecological Oncology, Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, Rome, Italy; ⁴Gynecologic Oncology, Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; ⁵Radiation Oncology Unit, Gemelli Molise Hospital, Università Cattolica del Sacro Cuore, Campobasso, Italy

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Purpose or Objective

The assessment of clinical response after exclusive chemoradiation in locally advanced cervical cancer (LACC) is recommended 3-6 months following completion of treatment, as per international guidelines. Aim of the present study was to investigate the best timepointfor assessing the clinical complete response in our series of LACC patients.

Material and Methods

atients with histologically proven squamous cell cervical cancer or adenocarcinoma, stage IB2-IVA FIGO 2018 were retrospectively analyzed. All patients received intravenous cisplatin (40 mg/m²/weekly), external beam radiotherapy (45 Gy in 25 daily fractions ± simultaneous lymph-nodes boost) and interventional radiotherapy (IRT, 28 Gy/twice/weekly). The primary endpoint was complete response evaluation, that we analysed at three timepoints with magnetic resonance imaging:

1) Assessment 1: At the end of external beam radiotherapy, before IRT (5-6 weeks from the start of treatment)

2) Assessment 2: 3 months after the end of IRT (18-20 weeks from the start of treatment)

3) Assessment 3: 6 months after the end of IRT (30-32 weeks from the start of treatment)

Results

63 patients (median age: 55 years; 2018 FIGO stage IA: 1, IIA: 3, IIB: 15; IIIA: 1; IIIC1: 29; IIIC2: 10; IVA: 3; IVB:1) were analyzed. 57 patients had a squamous cell carcinoma, 6 adenocarcinoma. The treatment was well tolerated with a satisfactory compliance.

Complete clinical response was achieved in 16 patients at assessment 1, 42 of patients at assessment 2, and 47 of patients at assessment 3. Seven Patients (53%) with a partial response at assessment 2 had a complete response at 6 months from the end of the treatment. Nine patients were missing at the third assessment. Six months after treatment 80% of clinical complete response was registered (Fig. 1).

We have a significative correlation with global overall survival at all assessments (Fig. 2).Fig 1.

Conclusion

Our data suggests that the optimal timepoint for assessment of complete clinical response after chemoradiation for LACC patients could be 6 months after exclusive treatment completion. This longer timeline could include patients not yet responders after 3 months, avoiding too early rescue therapies. Further and larger studies are needed to confirm this finding.