S471
Clinical - Gynaecological
ESTRO 2026
found correlation between week 4 CR- gastrointestinal (GI) symptoms and nodal boost, para-aortic irradiation (PAORT), bowelV50-V40 and bodyV50. We evaluated the weekly patient-reported (PRO) GI symptoms during RT for LACC and explored correlations with dosimetric parameters. Material/Methods: Retrospective unicentric study of LACC patients treated with radical pelvic VMAT (45Gy/25Fx +/-nodal simultaneous boost 55- 57.5Gy). PROs were collected using selected PRO-CTCAE2 items via mocile app at baseline and weekly during RT. Diarrhea and abdominal pain were graded as: none (A), mild (B), moderate (C), intense (D) or very intense/severe (E). Patients reporting moderate-severe symptoms for longer time (>25% of RT treatment) were classified as High Symptom Burden Group (HSB). Low Symptom Burden Group (LSBG) reported C-E for <25% of treatment. Evaluated dosimetric and volume data were PTV volumes, body, bowel, sigma and rectum. Clinical variables included smoking, depression, prior pelvic surgery, autoimmune disease, chemotherapy and BMI. Of 14 patients enrolled in PRO program between (11.2023-08.2025), 12 completed >2 questionnaires and were
95%CI 0.96-458.9) and had higher mean volumes of total (1211cc vs 757cc) and primary tumor (440cc vs 192cc), as well as greater rectumV30 (22cc vs 18cc) and V40 (12cc vs 9cc).
included. Results:
The 83% of patients responded >5 of 6 questionnaires (response rate: baseline: 100%, week 1: 100%, week 2: 92%, week 3: 83%,week 4: 83%, week 5: 75%).Moderate- intense diarrhea was reported by 75% of patients, peaking at fourth week. The HSB group (8/12) more frequently received PAORT (50% vs 0%) and nodal boost (75% vs 25%) and showed near-to-significance larger median PTVs (nodal areas 821cc vs 458cc; boost 21cc vs 0cc; total 1210cc vs 650cc). A trend towards worse diarrhea was seen in patients with autoimmune disease (OR=2.33, 95%CI 0.21-42.6). Moderate-intense abdominal pain occurred in 25% of patients, worse on second week. HSBG (4/12) more often received nodal boost or PAORT (OR=21,
Conclusion: Patient-reported moderate to very intense diarrhea is frequent during EBRT in LACC and varies over treatment, peaking on the fourth week. In contrast, this intensity of abdominal pain is less frequent and happens earlier, around second week. Larger PTV volumes, nodal boost, PAORT and higher doses to GI organs are seen in patients reporting longer- lasting and worse symptoms. These findings are consistent with EMBRACE-II findings,
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