S461
Clinical - Gynaecological
ESTRO 2026
neutropenia post NACT, without significant non-hematologic toxicities or treatment gaps during radical CTRT. One patient had disease progression and died. Conclusion: With the addition of NACT, the overall treatment time uniformly exceeded the 56- day threshold in all patients. Prolonged OTT favours accelerated tumor repopulation, potentially reducing any cytoreductive benefits from NACT. Upfront use of NACT in all locally advanced cervical cancers may be detrimental to long term outcomes and selected use of NACT can be probably considered following a multidisciplinary approach. Hence, given the effectiveness of modern radiotherapy techniques and HDR image guided brachytherapy achieving high local control rates without NACT, further consideration is warranted regarding the routine addition of NACT that may delay the standard definitive chemoradiation and offset potential survival advantage. References: McCormack M, Rincón DG, Eminowicz G, Diez P, Farrelly L, Kent C, Hudson E, Panades M, Mathews T, Anand A, Persic M. LBA8 A randomised phase III trial of induction chemotherapy followed by chemoradiation compared with chemoradiation alone in locally advanced cervical cancer: The GCIG INTERLACE trial. Annals of Oncology. 2023 Oct 1;34:S1276.Lindegaard JC, Kirisits C, Schmid MP, Wulff CN, Steen SG, Kristoffersen KB, Pötter R, Petric P. Impact of patient selection on real-world outcomes by using the EMBRACE-II treatment protocol in locally advanced cervical cancer. International Journal of Radiation Oncology* Biology* Physics. 2025 Jun 1. Keywords: cervix, overall treatment time, NACT
Digital Poster 2963
Towards refining normal tissue dose objectives beyond the EMBRACE II protocol in cervical cancer external beam radiotherapy Simona Š im ů nková 1 , Wolfgang Lechner 2,3 , Johannes Knoth 2,3 , Sarah Haupt 2 , Maximilian Schmid 2,3 , Nicole Eder-Nesvacil 2,3 , Christian Kirisits 2 , Dietmar Georg 2,3 , Petra Trnková 1 , Gerd Heillemann 2,3 1 Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic. 2 Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria. 3 Christian Doppler Laboratory for Image and Knowledge Driven Precision Radiation Oncology, Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria Purpose/Objective: The EMBRACE II study protocol is based on external beam radiotherapy (EBRT) dose objectives for cervical cancer radiotherapy (CC-RT), considering treatment planning approaches and treatment planning systems (TPS) available at that time in leading institutions of the EMBRACE consortium. [1] With the widespread adoption of image- guided VMAT and advancements of TPS, these objectives need to be reassessed to identify potential areas for further improvement. This study evaluated real- world treatment plans according to EMBRACE II dose objectives and explored achievable dose-volume parameters for organs of interest (OOIs) in today’s CC-RT setting. Material/Methods: The cohort included 150 CC patients (median age 54 years, range 27-85) treated with pelvic (n = 87) or pelvic + paraaortic (n = 63) VMAT EBRT between 2021 and 2024 following the EMBRACE II protocol. A total dose of 45 Gy, delivered in 25 fractions, was prescribed to the pelvis. A simultaneous nodal boost between 55-57,5 Gy was delivered in 34% of pelvic and 78% of pelvic + paraaortic
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