S46
Brachytherapy - Gynaecology
ESTRO 2026
acceptable, with no unexpected grade ≥ 3 toxicity. Conclusion: In ESCC FIGO 2018 IB2, 30–39 mm and N0, surgery ± POBT and CCRT + IGABT achieved comparable DFS and OS, with excellent pelvic control. The lower rate of metastatic relapse following CCRT + IGABT suggests that this treatment approach with concurrent chemotherapy may contribute to reducing metastatic events. Future randomized trials are required to confirm this signal and establish the optimal treatment strategy in this population. Keywords: Cervical cancer, chemoradiotherapy, brachytherapy References: Pötter R et al. Clin Transl Radiat Oncol 2018;9:48– 60.Tanderup K et al. Radiother Oncol 2016;120:441–6. Derks M et al. Acta Obstet Gynecol Scand 2016;95:166–72. Bataille B et al. Int J Gynecol Cancer 2020;30:181–6. Escande A et al. Gynecol Oncol 2017;144:541–6. Digital Poster 413 UNICURE - HD: Single - Insertion Image - Guided HDR Brachytherapy for Locally Advanced Cervical Cancer — Multicenter French Cohort Cyrus Chargari 1 , Lucie Houdou 2 , Francois Gardavaud 3 , Marie Bruand 4 , Kevin Quintin 2 , Antoine Mavrikios 1 , Sebastien Laroze 1 , Pierre Annede 5 , Laurie Monnier 6 , Claire Meynard 7 1 Radiation oncology, Pitié-Salpétrière, Paris, France. 2 Radiation oncology, Pitié-Salpétrière Hospital, Paris, France. 3 Radiology, Tenon Hospital, Paris, France. 4 Radiation oncology, Lorraine Oncology Institute, Nancy, France. 5 Radiation oncology, Saint Louis, Toulon, France. 6 Radiation oncology, Tenon Hospital, Paris, France. 7 Radiation oncology, Saint Louis Hospital, Paris, France Purpose/Objective: Purpose: Limited and uneven access to uterovaginal image - guided brachytherapy (IGABT) remains a barrier to timely (1,2), high - quality care in locally advanced cervical cancer (LACC).Objective: To evaluate feasibility, early oncologic outcomes, and severe toxicity of a single - implant IGABT strategy in a multicenter French cohort. Material/Methods: Material and Methods: We retrospectively analyzed 363 consecutive patients (FIGO 2009 IB–IVA) treated with concurrent chemoradiation (pelvic ± para - aortic EBRT delivered as 3D - CRT or IGRT/IMRT/VMAT, 45 Gy in 25 fractions) followed by one applicator insertion delivering four HDR fractions. Planning was MRI - centered with applicator in place when available; otherwise CT - based with fusion to a pre - implant MRI.
Digital Poster 323
Surgery or Chemoradiotherapy for Node-Negative Cervical Cancer FIGO 2018 IB2 30–39 mm: Does Chemoradiotherapy Reduce the Risk of Distant Relapse? GREGOIRE LAURENT DELANGHE 1 , SEVERINE RISBOURG 2 , DIANE SAYADI 3 , CARLOS MARTINEZ 4 , LUCIE BRESSON 4 , ANNE-SOPHIE NAVARRO 4 , FABRICE NARDUCCI 4 , ERIC LARTIGAU 1 , ABEL CORDOBA 1 1 University department of radiation oncology, Oscar Lambret Comprehensive Cancer Center, Lille, France. 2 Methodology and Biostatistics Unit, Oscar Lambret Comprehensive Cancer Center, Lille, France. 3 University department of radiation oncology, Leon Berard Comprehensive Cancer Center, Lyon, France. 4 University department of Gynaecological Surgery, Oscar Lambret Comprehensive Cancer Center, Lille, France Purpose/Objective: The optimal management of early-stage cervical cancer (ESCC) FIGO 2018 IB2 with tumor size between 30 and 39 mm and no nodal involvement remains controversial. We conducted this study to compare oncological outcomes of surgery ± preoperative brachytherapy (POBT) and definitive chemoradiotherapy (CCRT) followed by image-guided adaptive brachytherapy (IGABT) in this population. Material/Methods: Patients with ESCC 30–39 mm N0 treated between 2008 and 2022 were retrospectively included. Treatment consisted of radical surgery with or without POBT, or definitive CCRT (45–50 Gy with weekly cisplatin 40 mg/m ² ) followed by MRI-based IGABT, with allocation based on the treatment period and not on patient or tumor characteristics. Disease-free survival (DFS) was the primary endpoint; secondary endpoints were local/loco-regional and metastatic recurrence, and overall survival (OS). Survival outcomes were estimated using Kaplan–Meier and Cox models, with competing-risk analysis for specific events. Results: Eighty-two patients were included (47 surgery ± POBT, 35 CCRT + IGABT). Median follow-up was 106 months in surgery group and 49 months in chemoradiotherapy group. Baseline characteristics were comparable. No significant difference was observed in DFS (HR = 0.60 [0.23–1.56], p = 0.30) or OS (HR = 1.01 [0.23–4.50], p = 0.99). Pelvic control remained high in both groups (local/loco-regional recurrence <10%, csHR = 1.01 [0.23–4.50], p = 0.99). However, a marked decrease in metastatic recurrences was observed after CCRT + IGABT (17% vs 3%), with a strong trend toward significance consistent with a potential systemic effect of this strategy (csHR = 0.14 [0.02–1.11], p = 0.06). Treatment tolerance was
Made with FlippingBook - Share PDF online