S489
Clinical - Gynaecological
ESTRO 2026
survival (DMFS) were 83.2% (95% CI 76.5– 88.1) and 77.5% (95% CI 70.5–83.0), respectively. LRFS did not significantly differ between stages IIIC1 and IIIC2. In multivariable analysis, SIB (SHR 8.81, 95% CI 1.58–49.2, p = 0.013) and larger pelvic nodes (> 1.3 cm; SHR 4.63, 95% CI 1.25–17.1, p = 0.022) were significantly associated with higher LRF risk, while para-aortic involvement strongly predicted DM (SHR 10.17, 95% CI 1.67–61.7, p = 0.012). EFRT and chemotherapy regimen were not significantly associated with failure outcomes.
Conclusion: In this IGABT-based CCRT cohort, both boost technique and nodal characteristics were key determinants of disease control. SIB and larger pelvic nodes were associated with increased local–regional failure, while para- aortic involvement was the main predictor of distant metastasis. Refining nodal boost strategies may improve outcomes in high-risk LACC patients. References: Pötter R et al. MRI-guided adaptive brachytherapy in locally advanced cervical cancer (embrace-i): A multicentre prospective cohort study. The Lancet Oncology. 2021 Apr;22(4):538–47. Nomden CN et al. Nodal failure after chemo-radiation and MRI guided brachytherapy in cervical cancer: Patterns of failure in the embrace study cohort. Radiotherapy and Oncology. 2019 May;134:185–90. Narayan et al. Patterns of
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