S432
Clinical - Gynaecological
ESTRO 2026
R v4.3.3. Results:
A total of 1469 patients across 42 studies (91% retrospective) were included, with a median follow-up of 24.5 months (range: 1– 492). Of the included studies, 41% included cervical, 16% endometrial, and 43% all gynaecological cancers. Re-RT techniques were brachytherapy (BT) alone (23%), external beam radiation therapy (5%), BT ± EBRT (30%), intraoperative RT (5%), stereotactic body radiotherapy (5%), Seed BT (14%), and particle therapy (2%). Median reirradiation target EQD2Gy10 was 47.0Gy (range: 30.6-105.0). Meta-analysis of 13 studies yielded a pooled 2-year IFC of 66.2% (95% CI 57.6–74.8), with substantial heterogeneity (t ² =140.7; χ² =65.5, df=12, p<0.01; I ² =70%). (Figure 1) PFS and OS were variably reported: 2-year PFS ranged from 20.0–75.3% (median 56.3%) and 2-year OS ranged from 60.8–76.5% (median 69.5%). Grade ≥ 2 adverse events were reported in 17 studies (median 27.8%, range: 0–71%), Grade ≥ 3 in 30 studies (median 16.0%, range: 0–59%), and Grade 4–5 in 19 studies (median: 1.0%, range: 0–12%). (Figure 2) Only one study assessed quality of life. Concurrent chemotherapy was used in 27% of the studies; systemic therapies were combined with Re-RT in 39%; Bevacizumab in 2%; and no study used immunotherapy. Lower IFC was associated with larger tumours (>3–4cm), larger GTV volumes (>25–50cm ³ ), and higher grade. Favourable outcomes were linked to longer RT–ReRT intervals, use of image guidance for BT, use of interstitial BT, squamous histology. Higher EQD2Gy >40– 50Gy improved IFC, but adverse events increased beyond cumulative dose prescription of 130Gy EQD2.
Conclusion: This meta-analysis provides a pooled estimate of 2-year IFC following Re-RT in recurrent gynaecological cancers, with substantial heterogeneity across studies. Findings underscore the potential efficacy of Re-RT, whilst revealing variability in techniques, reporting, and outcomes, emphasizing the need for prospective, standardized studies. Keywords: Reirradiation, Metaanalyis, RECOG Proffered Paper 1754 Post-progression trajectory and survival in oligorecurrent, oligometastatic cervix cancer: Results from international multicentre RetroCOSMOS study. Supriya Chopra 1 , Mayuri Charnalia 2,3 , Magdalena Stankiewicz 4 , Wiwatchai Sittiwong 5 , Henrike Westerveld 6 , Tatsuya Ohno 7 , Dina Najjari Jamal 8 , Maura Campitelli 9 , Kevin Albuquerque 10 , Junzo Chino 11 , Lia Verhoef Verhoef 12 , Kathy Han 13 , Michal Czerwinski 14 , Gabriella Macchia 15 , Margit Valgma 16 , Maya Rottler 17 , Joanne Alfieri 18 , Fleur Huang 19 , Ankita Gupta 1 , Rene Vernhout 6 , Jeevanshu Jain 1 , Monica Serban 20,21 , Mischa Hoogeman 6,22 , Kari Tanderup 3,23 , Remi Nout 6 1 Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India. 2 Department of Radiation Oncology, ACTREC,Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India. 3 Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark. 4 Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland. 5 Division of Radiation Oncology, Department of
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