S47
Brachytherapy - Gynaecology
ESTRO 2026
Composite EBRT+BT doses were converted to EQD2 via the linear - quadratic model. Endpoints (local control [LC], pelvic/para - aortic nodal control, distant control, overall survival [OS], disease - free survival [DFS]) were estimated by Kaplan–Meier from end of radiotherapy. Severe late toxicity was CTCAE v5.0 grade ≥ 3. Results: Results: Feasibility was high: 99.4% completed the full brachytherapy course with a single implant. T2b predominated (59.5%); nodal involvement was 47.9%. Median overall treatment time (OTT) was 56 days (IQR 50–61). Median D90 - CTVHR was 85.9 GyEQD2 (IQR 80.4–91.6). At a median follow - up of 20.2 months, 3 - year LC was 83.1%. At 36 months, LC was 88.4% for D90 - CTVHR >90 GyEQD2 and—on unadjusted Kaplan– Meier—higher with MRI - centered than CT–MRI fusion planning (93.5% [95% CI 85.7–97.2] vs 78.5% [70.4– 84.6]). LC by OTT: 94% (<50 d), 89% (50–55 d), 81% (>55 d). Severe late toxicity was infrequent: GU 3.8%, rectal 4.7%, GI 1.7%, vaginal 3.9%; no grade - 5 events. Conclusion: Conclusion: Local control was high overall particularly with MRI - centered, applicator - in - place planning. Single - implant HDR - IGABT was feasible and yielded a safety profile broadly consistent with historical multi - insertion series. Lower LC versus EMBRACE II likely reflects protracted OTT amid variably developed brachytherapy facilities. This simplified approach may improve access and reduce resource use if rigorous image guidance and dose - constraint adherence are maintained. Longer follow - up and expanded accrual will refine durability and prognostic analyses. Keywords: Single-implant, MRI-centered, cervix carcinoma References: 1. Safety and efficacy of single insertion accelerated MR-image guided brachytherapy following chemo– radiation in locally advanced cervix cancer: modifying our EMBRACE during the COVID pandemic | Radiation Oncology | Full Text [Internet]. [cité 20 sept 2025]. Disponible sur: https://ro- journal.biomedcentral.com/articles/10.1186/s13014- 023-02240-52. Bauer-Nilsen K, Hill C, Trifiletti DM, Libby B, Lash DH, Lain M, et al. Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing. Int J Radiat Oncol Biol Phys. 1 janv 2018;100(1):88 - 94.
Digital Poster 536 Mapping multi-regional regional brachytherapy practice for cervical cancer: results of a comprehensive survey Khadiga Mohammed 1,2 , Carol Johnson 2 , Ikram Burney 1 , Syeda Sara Tajammul 1 , Nadeem Pervez 3 , Moazzama ibrahim 4 1 Radiation Oncology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, University Medical City (SQCCCRC/UMC), Muscat, Oman. 2 Radiation Oncology, Wellington Hospital, Wellington, New Zealand. 3 Radiation Oncology, Gulf International Cancer Centre - Abu Dhabi (GICC), Abu Dhabi, UAE. 4 Genetic Counselling and screening, University of Central Punjab, Lahore, Pakistan Purpose/Objective: Brachytherapy (BT) is a keystone of curative treatment for locally advanced cervical cancer (LACC). Radiation oncologists practicing in the Middle East, North Africa, Turkey and Asia-Pacific regions (MENAT-ASP) were surveyed to study and report patterns of practice of delivering BT, imaging and applicator use, and barriers to advanced BT implementation Material/Methods: A web-based questionnaire was distributed via the Asia-Pacific and Middle East Society of Therapeutic Radiation and Oncology (AMSTRO) and Asia-Pacific Radiation Oncology Network (ASPRONET) platforms to radiation oncologists across the MENAT-ASP regions between May and August 2025. The survey collected data evaluating BT practice patterns for LACC, imaging modalities used for planning [magnetic resonance imaging (MRI) or computed tomography (CT)], the use of image-guided adaptive brachytherapy (IGABT) and interstitial brachytherapy, applicator types, and perceived barriers. Responses were summarised using descriptive statistics. Results: Eighty-three responses were received, with 74% from academic or university centres. Just under half (44.6%) of the respondents reported a clinical focus on gynaecological radiotherapy. BT services were available in 91.5% of centres, predominantly using high-dose-rate (HDR) techniques. Among centres without BT access, all but one referred patient elsewhere.A total of 79% of respondents reported not using external beam radiotherapy (EBRT) boost as a substitute for BT. When EBRT boost is delivered, 77.3% use advanced techniques such as volumetric modulated arc therapy (VMAT) or intensity-modulated radiotherapy (IMRT), followed by stereotactic body radiotherapy (SBRT) in 36.3%, and other methods in 13%. HDR procedures were performed in a dedicated suite in 81% of centres.MRI-based delineation was used in 38% of centers; CT planning dominated (84%),
Made with FlippingBook - Share PDF online