S90
Brachytherapy - Gynaecology
ESTRO 2026
1 Radiotherapy, Regional Institute of Oncology, Iasi, Romania. 2 Surgery, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania. 3 Physics, Regional Institute of Oncology, Iasi, Romania Purpose/Objective: This study aimed to evaluate the clinical impact of image-guided adaptive brachytherapy (IGABT) in the management of locally advanced cervical cancer (LACC) over a six-year period in a resource-constrained setting. Material/Methods: A total of 127 consecutive patients with LACC treated between April 2018 and October 2024 were included. All patients received external beam radiotherapy (EBRT) with nodal boost delivered sequentially or as a simultaneous integrated boost (SIB), with concurrent chemotherapy, followed by high-dose-rate (HDR) IGABT. Target delineation for the high-risk CTV (CTVHR), intermediate-risk CTV (CTVIR), as well as organs at risk (OARs: bladder, rectum, sigmoid, and small bowel), followed GEC-ESTRO recommendations. Cumulative doses were expressed as EQD2 values using the linear–quadratic model. The overall treatment time (OTT) goal was ≤ 50 days. Follow-up was conducted every 3 months for the first 2 years and every 6 months thereafter. Late morbidity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE). Statistical analyses explored clinical and dosimetric predictors of late toxicity. Clinical outcomes included local control, disease-free survival (DFS), overall survival (OS), and treatment-related toxicities. Results: The median patient age was 56 years. Disease stages included IIB (n=39), IIIC1r (n=60), IIIC2r (n=254), and IVA (n=4). Mean D90 for the CTVHR and CTVIR were 86 Gy and 65 Gy, respectively. Median doses to D2cc to the bladder, rectum, sigmoid, and bowel were 81 Gy, 67 Gy, 65 Gy, and 60 Gy, respectively. Median doses of D0.1cc for bladder, rectum, sigmoid, and small bowel were 98.3 Gy, 74.5 Gy, 73 Gy and 65.8 Gy, respectively. 83 patients achieved the planned OTT. After a median follow-up of approximately 72 months, 90% achieved locoregional remission. The incidences of genitourinary (GU) and gastrointestinal (GI) morbidity were 14.5% and 13.6%, respectively. Grade 2–3 late morbidity occurred in 22.3% of patients. For GU toxicity, 5 of 6 patients with ≥ grade 2 events had D2ccbladder ≥ 80 Gy (EQD2–3). For GI toxicity, 7 of 11 patients with ≥ grade 2 events had D2ccrectum ≥ 65 Gy, and 6 had D2ccsigmoid ≥ 65 Gy. The 6-year OS, DFS, and local control rates were 76%, 69%, and 82%,
favorable local control and survival outcomes with acceptable toxicity. The findings support the integration of IGABT as a standard component of cervical cancer management in developing countries. Keywords: cervical cancer, image guided brachytherapy
Digital Poster 5072
Trends in brachytherapy use and survival in cervical cancer: Insights from a high-volume oncology centre in Nigeria. BOLANLE COMFORT ADEGBOYEGA 1,2 , TEMITOPE ANDERO 1 , Chidiebere Agbakwuru 1 , BUKOLA OSHIKANLU 1,2 , EBEN AJE 1 , GODWIN UWAGBA 1 , ADEDAYO JOSEPH 1 , ADEWUMI ALABI 1,2 , MUHAMMAD HABEEBU 1,2 , ANTHONIA SOWUNMI 1,2 1 Medserve-LUTH Cancer Center, Medserve-LUTH Cancer center, Lagos, Nigeria. 2 Radiotherapy, Lagos University Teaching Hospital, Lagos, Nigeria Purpose/Objective: This study aimed to determine the trends in brachytherapy utilisation among cervical cancer patients. Material/Methods: We conducted a retrospective study of all cervical cancer patients treated with brachytherapy at the NSIA-LUTH Cancer Centre between March 2021 and June 2024 using electronic clinical. A total of 480 cervical patients were recorded during the study period and 182 had brachytherapy. Descriptive statistics and the Kaplan-Meier survival analysis were used to analyze the data using SPSS version 27, and a p-value less than 0.05 was considered statistically significant Results:
An increase in brachytherapy utilization was observed from 25.7% in 2021 to 60.7% in 2024. Of Tre self- employed, 130 (71.4%) were married. 92 (52.5%) had no comorbidity. The most common presenting symptoms were bleeding per vagina (79.7%), abnormal vaginal discharge (53.3%), and abdomino- pelvic pain (27.5%). Advanced stage presentation was common; stage I (13.2%), stage II (45.6%), stage III
respectively. Conclusion:
IGABT is a feasible and effective treatment option for LACC even in resource-limited settings, achieving
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