S74
Brachytherapy - Gynaecology
ESTRO 2026
Digital Poster 3624
the local ethics committee. Data were obtained from medical records and analyzed using STATA 19 (StataCorp LLC, USA), generating descriptive statistics and Kaplan–Meier survival curves. Results: A total of 250 patients were included, with a median follow-up of 40 months. The median age was 48 years (IQR 37–59). Non-squamous histologies comprised 16.8% of the cohort. Disease stage distribution was: Stage I, 21.3%; Stage II, 32.1%; and Stages III–IV, 46.6%. Most patients (94.3%) received a median of five cycles of weekly cisplatin (IQR 4–5). External beam treatment was delivered using 3DCRT in 51.6% and VMAT in 48.4% of cases. A mean of 3.1 HDR-IGABT fractions were delivered per patient, with a median prescribed dose of 8,5 Gy per fraction. 10 patients underwent interstitial brachytherapy. When integrating EBRT and IGABT contributions, the mean total dose to the HR- CTV corresponded to 84 Gy EQD2 (median 83.6 Gy, IQR 83.4–84.9 Gy). The estimated 3-year overall survival (OS) was 80% for the entire cohort: 92% for Stage I, 86% for Stage II, and 72% for Stages III–IVA. Conclusion: The implementation of image-guided adaptive brachytherapy following concurrent chemoradiotherapy in the Chilean public health-care setting achieved outcomes comparable to those reported by international series. The protocol demonstrated satisfactory overall survival, particularly in early stages, and confirms the feasibility and effectiveness of IGABT in a resource-constrained environment. These results support the continued expansion and optimization of IGABT as a standard component of cervical cancer management within the Chilean public system. Keywords: Image-guided adaptive brachytherapy (IGABT) References: 1. Pötter R, Chargari C, et al. MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): a multicentre prospective cohort study. Lancet Oncol. 2021;22(4):538-547.2. Sturdza A, Pötter R, Fokdal LU, Haie-Meder C, Tan LT, Mazeron R, Petric P, Š egedin B, Jurgenliemk-Schulz IM, Nomden C, et al. Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study. Radiother Oncol. 2016;120(3):428-433. doi:10.1016/j.radonc.2016.03.011.
Initial Outcome of advanced vaginal recurrences treated with EBRT and MR Adaptive Interstitial Brachytherapy using GEC-ESTRO(ACROP)–ABS–CBG guidelines Harjot K Bajwa 1 , Rajesh Natte 1 , Sushil Beriwal 2 , Suresh Chaudhari 3 1 Radiation Oncology, American Oncology Institute, Hyderabad, India. 2 Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, USA. 3 Radiation Physics, American Oncology Institute, Hydearabad, India Purpose/Objective: The GEC-ESTRO (ACROP)–ABS–CBG consensus brachytherapy target definition guidelines for MR brachytherapy in recurrent Endometrial and Cervical tumors in the vagina were published recently.There is very limited outcome data using these guidelines. This study aims to report the outcomes of post hysterectomy locally advanced vaginal recurrences treated with EBRT and MR Adaptive interstitial brachytherapy using the above guidelines Material/Methods: Patients diagnosed to have recurrence in the vagina post hysterectomy and treated with definitive chemoradiation followed by MR adaptive interstitial brachytherapy were included in the study. GTV-Tres, CTV-T HR and CTV-T IR were contoured on T2 MR images with applicator in place as per the guidelines. The outcome parameters analyzed were local control and late morbidity Results: A total of 15 patients were included in the analysis. None of the patients received radiotherapy in the past. 47% patients had bladder or bowel infiltration and 40% had tumor width more than 5cm at diagnosis. 40% patients had regional lymph node involvement. 66% patients had squamous histology and 44% had adenocarcinoma histology. All patients received 45- 50Gy EBRT followed by HDR interstitial brachytherapy to a dose of 24-28Gy in 3-4 fractions using the MR compatible Kelowna interstitial template and needles. No patient had complete response to EBRT. The mean HRCTV volume was 21cc (10-59.5cc). The mean EQD2 dose to D98 GTV-Tres, D90 CTV-T HR and D98 CTV-T IR were 87.6Gy(85-95Gy), 84Gy(80-90 Gy) and 62.3Gy(60- 74Gy), respectively. The mean EQD2 doses to D2cc Bladder, Rectum and Bowel were 70.8Gy(64.3-78Gy), 64.1Gy(57.6-7-Gy) and 54Gy(50-66Gy), respectively. Median follow up was 18 months (8-30 months). 2 patients developed local recurrence which was within the CTV-T HR volume. The 2-year actuarial local control rate was 84.8%. One patient developed distant metastasis and one patient died due to disease progression. Four patients had late grade 2 GI or GU
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