S435
Clinical - Gynaecological
ESTRO 2026
Mahantshetty 1 , Sudeep Gupta 7 , Kedar Deodhar 8 , Surbhi Grover 9 1 Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India. 2 Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer, Homi Bhabha National Institute, Navi Mumbai, India. 3 Pathology, Advanced Centre for Treatment Research and Education in Cancer, Homi Bhabha National Institute, Navi Mumbai, India. 4 General Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India. 5 Medical Oncology, Advanced Centre for Treatment Research and Education in Cancer, Homi Bhabha National Institute, Navi Mumbai, India. 6 Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA. 7 Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India. 8 Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India. 9 Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA Purpose/Objective: Treatment of cervical cancer in women with Human Immunodeficiency Virus (HIV) co- infection may be heterogenous. The aim of this study was to evaluate late adverse events and survival outcomes after chemoradiation and brachytherapy in women living with or without HIV. Material/Methods: Patients diagnosed with cervical cancer FIGO 2018 Stage IB2-IVA were prospectively enrolled from 2021– 2024 in 2:1 ratio (120 HIV negative: 60 HIV positive) to receive chemo-radiation (CRT) and brachytherapy (BT) (Clinical Trial ID: NCT07167069). Late adverse events (AEs) were captured using CTCAE Version 5. Disease control and survival outcomes were assessed using Kaplan Meier method and compared using chi square test. Results: Of the 180 enrolled patients, 7 patients did not receive any treatment (4 HIV negative and
3 HIV positive). Remaining 173 patients were analyzed for study outcomes. Median CD4 counts for HIV positive patients were 591 cells/mm3 (114 – 1692). Concurrent weekly cisplatin was received by 93.1% HIV negative and 82.5% HIV positive women (p=0.03). Median follow up was 34 months (IQR- 29-39 months). There were no differences in the treatment parameters, treatment completion rates or late Grade >2 Gastro- intestinal (GI) and Genito- urinary (GU) AEs (Table 1). No differences were found in terms of Grade ≤ 2 late GI (45.6% vs 44.8%, P= 0.34) and GU AEs (19.3% vs 23.3%, P= 0.88) between HIV positive and HIV negative cohort. Most common late GU AEs was dysuria. In terms of late GI AEs, most of the patients experienced proctitis and abdominal pain. 22.4% HIV negative patients and 15.8% HIV positive patients had any type of disease failure (P= 0.3). Local (8.8% vs 7.8%, P= 0.81), nodal (8.8% vs 6%, P= 0.5) or distant failure (8.8% vs 18.9%, P= 0.08) were comparable between both the groups.Most common distant metastasis site was lung (7% vs 13.8%, P= 0.19). HIV negative cohort experienced more non-regional lymph node recurrences (0% vs 8.6%, P= 0.02). There were no statistical differences in terms of 3 year local (89.2% vs 91.5%, p= 0.65), loco-regional (85.5% vs 87.6%, p= 0.63), distant control (79.2% vs 90.1%, P= 0.15), disease free survival (DFS) (70.4% vs 72.7%, P= 0.60) and overall survival (OS) (71.7% vs 80.9%, P= 0.16).
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