S484
Clinical - Gynaecological
ESTRO 2026
therapy included weekly cisplatin 40 mg/m ² ± pembrolizumab 200 mg; one patient discontinued chemotherapy after cycle one due to grade 3 haematologic toxicity. Acute toxicity was graded (CTCAE v5) as gastrointestinal (GI), genitourinary (GU), haematologic, or fatigue. Median overall treatment time was 48 days [IQR 45–52]; median follow-up, 3 months [IQR 1.6–3.4]. Results: Grade 2 toxicity occurred in three patients (38%), mainly GI (n=2) and haematologic (n=1); no ≥ G3 GI/GU events were reported. Fatigue/asthenia was observed in five patients (63%, grade 1–2). ≥ G2 toxicity rates were comparable between cisplatin ± pembrolizumab (2/5 vs 1/3; p=1.00) and HDR- BT 5 × 6 vs 4 × 7 Gy (1/1 vs 2/7; p=0.38). At a median follow-up of 3 months [IQR 1.6–3.4], all patients were alive and disease-free, and overall acute toxicity remained low. Conclusion: Adaptive radiotherapy with Ethos™ integrated into standard chemoradiation for cervical cancer was clinically feasible, efficient, and well tolerated. The workflow proved robust and reproducible, supporting its safe implementation in multidisciplinary cervical cancer management. Keywords: Adaptative radiotherapy, Ethos, Cervical cancer hematologic toxicity based on dynamic CT images for cervical cancer patients during concurrent chemoradiotherapy Lu Li 1 , Qian yue Guo 2 , Ming Fan 1 , Ping qing Yin 3 , Ke Yuan 1 , Zhou ya Ren 4 , Chao qi Zhou 5 , Yi jin Lang 1 , Mei Feng 3,1 1 Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of Digital Poster Highlight 4475 A phase II study on prediction of
China, chengdu, China. 2 Department of Medical Oncology, Yibin Second People's Hospital, yibin, China. 3 Department of Medical Oncology, The Third People’s Hospital of Sichuan, chengdu, China. 4 School of Computer Science and Engineering, University of Electronic Science and technology, chengdu, China. 5 Research and Development Department, Manteia Data Technology Co., Ltd, xiamen, China Purpose/Objective: Hematologic toxicity is a common side effect during concurrent chemoradiotherapy (CCRT) for cervical cancer patients, primarily resulting from radiation-induced injury to the pelvic bone marrow. However, the predictive research about radiomics was very limited. It especially lacks the dynamic image changes during radiation. This study aims to observe the dynamic CT image changes and explore the possible association among delivered dose, hematologic toxicity and CT image changes in pelvic bone for cervical cancer patients . Material/Methods: This study enrolled cervical cancer patients with radical CCRT. They underwent contrast-enhanced CT scans for pelvic bone at three time points: before radiotherapy(0th), 10th radiation fraction and 25th radiation fraction. On the CT images, regions of interest were delineated in the lumbar vertebra area (L1-L4), sacrococcygeal area (L5 + sacrum + coccyx), and hip bone area (ilium + ischium + pubis) targeting the low-density areas within the bone cortex. MIM software was used to automatically measure the three-dimensional mean CT values of these areas. ANOVA was used to assess the dynamic changes in CT values. Pearson analysis was employed to explore the associations of the radiation dose and CT values. Logistic regression was adopted to analyze risk factors associated with hematologic toxicity.
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