S439
Clinical - Gynaecological
ESTRO 2026
e, J. W., & Seol, K. H. (2021). Pretreatment Neutrophil-to-Lymphocyte Ratio Combined with Platelet-to-Lymphocyte Ratio as a Predictor of Survival Outcomes after Definitive Concurrent Chemoradiotherapy for Cervical Cancer. Journal of Clinical Medicine, 10(10), 2199. https://doi.org/10.3390/jcm10102199 Keywords: Cervical, hematologic toxicity Digital Poster Highlight 1993 Numerical scoring of adaptive and nonadaptive teletherapy rival plans in locally advanced cervical cancer using in- silico planning Pournima S. Kale, Rupesh D. Sonawane, Nilavarasu Shanmugan, Pallavi Kalbande, Niloy R. Datta Department Radiation Oncology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India Purpose/Objective: External beam radiation therapy (EBRT), whether 3D-CRT or IMRT with image guidance, is an integral part of teletherapy for locally advanced cervical cancer (LACC). Non-adaptive vs. adaptive EBRT techniques need to account for primary tumour regression and relative changes in the spatial position of organs-at-risk (OAR) during EBRT. The study aims to systematically evaluate, numerically score, and rank various EBRT plans in LACC. Material/Methods: Pre-brachytherapy EBRT plans for 50 Gy were evaluated. For adaptive EBRT, replanning was performed on the re-CECT images obtained at 30 Gy. The rival plans evaluated include – nonadaptive snapshot(s) plans (a) 3D-CRT (s3D-CRT) or (b) IMRT (sIMRT) for the entire 50 Gy, based on initial pretreatment CECT scans or adaptive plans with (c) Hybrid 3D- CRT (phase I: 0-30 Gy) followed by replanned(r) IMRT (phase II: 31-50 Gy)(HART) or (d) Adaptive IMRT (AIMRT) with sIMRT in
None of the pre-treatment inflammatory biomarkers (NLR, PLR, MLR, SII, SIRI, AISI) demonstrated significant association with acute grade 2+ hematologic toxicity during concurrent chemoradiation.
For survival outcomes, NLR was significantly associated with 5-year overall survival (p=0.033), with patients having elevated NLR>2.4 demonstrating lower survival rates compared to those with NLR ≤ 2.4. This finding aligns with published literature indicating high pre-CCRT NLR predicts shorter survival periods. The remaining biomarkers (PLR, MLR, SII, SIRI, AISI) showed no significant associations with either 3-year or 5-year OS. Conclusion: Elevated pre-treatment NLR predicts worse 5- year survival but inflammatory biomarkers do not predict acute hematologic toxicity during chemoradiation. References: Wu, J., Chen, M., Liang, C., & Su, W. (2017). Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review. Oncotarget, 8(8), 13400–13412. https://doi.org/10.18632/oncotarget.14541 Le
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