ESTRO 2022

Session Item

Gynaecological

Session Type: Poster (digital)

Track: Clinical

Journey:

Stereotactic body re-irradiation for gynaecological cancer: outcomes and toxicities

Donato Pezzulla, Italy

Presentation Number: PO-1354

Abstract

Abstract Title:

Stereotactic body re-irradiation for gynaecological cancer: outcomes and toxicities

Authors:

Donato Pezzulla¹, Gabriella Macchia², Milena Ferro², Savino Cilla³, Milly Buwenge^4,5, Mariangela Boccardi², Carmela Romano³, Silvia Cammelli⁶, Paolo Bonome², Marica Ferro², Vincenzo Valentini^7,8, Alessio Giuseppe Morganti^9,10, Francesco Deodato^2,11

¹ Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; ²Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; ³Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Medical Physics Unit, Campobasso, Italy; ⁴IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Radiation Oncology, Bologna, Italy; ⁵DIMES, Alma Mater Studiorum Bologna University, Department of Experimental, Diagnostic, and Specialty Medicine , Bologna, Italy; ⁶IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Radiation Oncology, Bologna, Italy; ⁷Fondazione Policlinico Universitario A Gemelli IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Roma, Italy; ⁸Università Cattolica del Sacro Cuore, Istituto di Radiologia , Roma, Italy; ⁹IRCCS Azienda Ospedaliero-Universitaria di Bologna, Radiation Oncology, Bologna, Italy; ¹⁰DIMES, Alma Mater Studiorum Bologna University, Department of Experimental, Diagnostic, and Specialty Medicine, Bologna, Italy; ¹¹Università Cattolica del Sacro Cuore, Istituto di Radiologia, Roma, Italy

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Purpose or Objective

To report the toxicity profile, local control (LC) rate and Quality of life (QoL) data in patients suffering from recurrent gynaecological cancer undergone stereobody radiotherapy (SBRT) retreatment.

Material and Methods

Data from patient folders were retrospectively collected, focusing in particular on primary, previous systemic therapies and previous radiotherapy treatments. Concerning SBRT, the total dose (5 daily fractions) was delivered with a linear accelerator using VMAT technique. Acute and late toxicities were assessed by the RTOG/EORTC scales. The quality of life (QoL) was evaluated according to the CLAS 1 (fatigue), 2 (energy level), 3 (daily activities) scales.

Results

23 patients (median age 67 years, range 48-80) bearing 27 lesions were treated from December 2006 to August 2021. The majority of patients had ovarian (39.1%) and endometrial cancer (39.1%) as the primary tumor. The most used SBRT schedules were 30 Gy (37.0%), 35 Gy (29.6%) and 40 Gy (29.0%). More details are shown in Table 1.

With a median follow-up of 18 months (range 1-95), no patients presented acute or late toxicities higher than grade 2, except for one case of grade 4 bone toxicity (fracture) 26 months after SBRT. This patient was treated for a sacral lesion with 40 Gy, having previously received 45 Gy on the pelvic nodal area. One year- and 2 years-LC were 84.0% and 76.3% respectively (Image 1), while the 1 year- and 2 years-OS were 81.6% in both cases. The overall clinical response rate was 70.8% with a complete response rate of 65.4%.

Regarding QoL, no statistically significant difference was found between the baseline and follow-up values: the median CLAS1, CLAS2 and CLAS3 was 6 (range 4-10) at baseline for each category, and still 6 (range 3-10) one month after SBRT.

Conclusion

According to this preliminary experience, in-site SBRT retreatment for recurrent gynaecological cancer could be considered a quite feasible and safe treatment without any short-term QoL impairment.