S438
Clinical - Gynaecological
ESTRO 2026
Offline Magnetic Resonance Guidance: The Modular Adaptive Radiotherapy System (MARS). Cancers 16(2024).3. Weykamp, F., et al. Daily AI-Based Treatment Adaptation under Weekly Offline MR Guidance in Chemoradiotherapy for Cervical Cancer 1: The AIM-C1 Trial. Journal of clinical medicine 13(2024). Keywords: Online adaptive radiotherapy Digital Poster 1971 Predictive Value of Pre-Treatment CBC- based Inflammatory Biomarkers on Acute Hematologic Toxicity in Locally Advanced Cervical Cancer Chemoradiation Rosa Lea S Baldevarona 1 , Maria Lourdes B Lacanilao 1 , Quennie J Paylaga 1 , Aldrich Ivan Lois D Burog 2 , Emilio III Q Villanueva 3 1 Radiological and Imaging Sciences, Southern Philippines Medical Center, Davao City, Philippines. 2 Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines. 3 Anatomic and Clinical Pathology, University of the Philippines College of Medicine, Manila, Philippines Purpose/Objective: This study determines the predictive value of pre-treatment leukocyte-based systemic inflammatory biomarkers for acute hematologic toxicity in locally advanced cervical cancer patients undergoing concurrent chemoradiation. While traditional prognostic factors predict overall survival (OS), they inadequately capture individual toxicity susceptibility. We investigate readily accessible inflammatory biomarkers (neutrophil-lymphocyte ratio/NLR, platelet- lymphocyte ratio/PLR, monocyte-lymphocyte ratio/MLR, systemic inflammatory index/SII, systemic inflammation response index/SIRI, aggregate index of systemic inflammation/AISI) derived from routine complete blood counts (CBC). We assessed their association with acute hematologic toxicity and long-term survival outcomes among stages IB3-IVA patients receiving definitive platinum-based chemoradiation at
Southern Philippines Medical Center (SPMC), aiming to enhance risk stratification and enable personalized treatment strategies in resource-limited settings. Material/Methods: This retrospective analytical study included LACC patients who completed definitive chemoradiation (EBRT 45-50.4 Gy, brachytherapy 28.8-36 Gy, 5-6 platinum- based chemotherapy cycles) at SPMC Radiation Oncology Section from March 2018 to March 2020. Total enumeration sampling yielded approximately 50 patients, 41 of which had sufficient clinical data. Pre- treatment and serial CBC data were extracted from medical records to calculate NLR, PLR, MLR, SII, SIRI, and AISI. Primary outcomes included grade 2+ acute hematologic toxicity and 3-year/5-year overall survival. Statistical analysis employed descriptive statistics, chi- square/Fisher exact tests, univariable/multivariable logistic regression addressing multicollinearity through correlation assessment and variance inflation factors, and survival analysis using SPSS version 24.0. Results: Forty-one LACC patients (mean age 46.1±9.9 years) were analyzed. Most presented with FIGO Stage IIB disease (56.10%), squamous cell histology (73.17%), bulky tumors ( ≥ 4cm), and enlarged pelvic lymph nodes (70%). Extended-field radiation therapy was administered to 58.54%. Single-agent platinum chemotherapy was used in 97.5%, while 68.29% required anemia management. Mean EBRT duration was 38±1 days, with total elapsed treatment time of 154±73 days, exceeding the critical 56-day threshold associated with compromised outcomes.
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