S483
Clinical - Gynaecological
ESTRO 2026
pathological information, such as age, tumor operability, and FIGO stage. Standard parametric and nonparametric tests were used in statistical studies to evaluate intergroup differences; p < 0.05 was considered significant. Results: Overall, there was a modest increase in mean serum NGAL levels during therapy (from 134.78 to 144.46 ng/mL; p = 0.284), but this change was not statistically significant for the overall group. On the other hand, NGAL levels were positively connected with more advanced FIGO stages (p = 0.074) and increased significantly (p = 0.021) among inoperable patients. Post-treatment NGAL levels were either steady or slightly reduced in operable individuals. Women between the ages of 51 and 60 had the highest total HPV positive rate (72.73%), with HPV16 emerging as the most common subtype (26.03%). Serum NGAL levels and the distribution of HPV subtypes did not significantly correlate (p > 0.05). Conclusion: Elevated levels in advanced and incurable cases indicate possible prognostic relevance, even though NGAL does not seem to be a sensitive short-term indication of therapy response. Rather than a direct interaction between HPV subtypes, the biomarker most likely represents inflammation linked to tumors. These results encourage the use of NGAL in upcoming multi-marker prognostic panels, pending confirmation in more extensive, long-term research. The significance of ongoing screening and early therapeutic intervention is further highlighted by midlife women's persistent HPV infection. References: Abudula, A.et al (2020). Tissue-based metabolomics reveals potential biomarkers for cervical carcinoma and HPV infection. Bosnian Journal of Basic Medical Sciences. https://doi.org/10.17305/bjbms.2019.4359Ba rtosik, M.et al. (2024). Advanced technologies towards improved HPV diagnostics. Journal of
Medical Virology, 96(2), e29409. https://doi.org/10.1002/jmv.29409Bitsouni, V.et al (2024). From primary HPV infection to carcinoma in situ: A mathematical approach of cervical intraepithelial neoplasia. arXiv. https://doi.org/10.48550/arXiv.2403.13302Ca stro-Oropeza,(2022).Epigenetic and Transcriptomic Regulation Landscape in HPV+ Cancers: Biological and Clinical Implications. Frontiers in Genetics, 13. https://doi.org/10.3389/fgene.2022.886613 Keywords: NGAL, HPV, biomarker-cervical cance, Digital Poster 4404 Clinical implementation and early outcomes of adaptive radiotherapy with Ethos™ for cervical cancer Jennifer Hernández 1 , Irene Císcar 1 , Vanessa Ortiz 1 , Miguel Martínez 2 , Ana Corbalán 2 , Alberto Espinosa 1 , Virginia Alonso 1 , Pedro Pablo Escolar 1 , Silvia Rodríguez 1 , Vicente Luis García 1 , Alfredo Serna 2 , Juan Salinas 1 1 Radiation Oncology, Complejo Hospitalario Universitario, Cartagena, Spain. 2 Medical Physics and Radiation Protection, Complejo Hospitalario Universitario, Cartagena, Spain Purpose/Objective: To evaluate acute tolerance, treatment delivery times, and early clinical outcomes in cervical cancer patients treated with daily adaptive external beam radiotherapy (EBRT) on the Ethos™ platform, integrated with
concurrent chemotherapy and/or immunotherapy and High Dose Rate brachytherapy (HDR-BT) within a multidisciplinary workflow. Material/Methods:
Eight patients with locally advanced cervical cancer (median age 47.5 years [IQR 42–53]) were treated with daily online adaptive EBRT (25 × 1.8 Gy) to pelvis ± para-aortic nodes (45 Gy) with adaptive boosts (10–11 Gy) to tumour and nodal targets, followed by HDR- BT 4 × 7 Gy (n=7) or 5 × 6 Gy (n=1). Systemic
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