ESTRO 2023

Session Item

Saturday

May 13

09:00 - 10:00

Stolz 1

Gynaecology

Chair: , The Netherlands;

Co-Chair: Safia Yahiaoui, Tunisia

Session Type: Mini-Oral

Track: Clinical

Journey:

SBRT in oligometastatic uterine cancer: a large, multicenter, retrospective study.

, Italy

Presentation Number: MO-0051

Abstract

Abstract Title:

SBRT in oligometastatic uterine cancer: a large, multicenter, retrospective study.

Authors:

Gabriella Macchia¹, Donato Pezzulla¹, Maura Campitelli², Concetta Laliscia³, Andrei Fodor⁴, Paolo Bonome¹, Lorena Draghini⁵, Edy Ippolito⁶, Vitaliana De Sanctis⁷, Martina Ferioli⁸, Francesca Titone⁹, Vittoria Balcet¹⁰, Vanessa Di Cataldo¹¹, Donatella Russo¹², Lisa Vicenzi¹³, Sabrina Cossa¹⁴, Simona Lucci², Francesco Deodato^1,15, Maria Antonietta Gambacorta^2,16, Gabriella Ferrandina¹⁷

¹Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; ²Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Roma, Italy; ³University of Pisa, Department of Translational Medicine, Division of Radiation Oncology, Pisa, Italy; ⁴IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, Milano, Italy; ⁵S Maria Hospital, Radiation Oncology Center, Terni, Italy; ⁶Campus Bio-Medico University, Department of Radiation Oncology, Roma, Italy; ⁷Sapienza University of Rome, S. Andrea Hospital, 7Radiotherapy Oncology, Department of Medicine and Surgery and Translational Medicine, Roma, Italy; ⁸Alma Mater Studiorum - Bologna University, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Bologna, Italy; ⁹University Hospital Udine, Department of Radiation Oncology, Udine, Italy; ¹⁰Ospedale degli Infermi, Radiation Oncology Department, Biella, Italy; ¹¹University of Florence, Radiation Oncology Unit, Oncology Department, Firenze, Italy; ¹²Ospedale "Vito Fazzi", Radiotherapy Unit, Lecce, Italy; ¹³Azienda Ospedaliera Universitaria Ospedali Riuniti, Radiation Oncology Unit, Ancona, Italy; ¹⁴Fondazione "Casa Sollievo della Sofferenza", IRCCS, S. Giovanni Rotondo, UOC Radioterapia, Foggia, Italy; ¹⁵ Università Cattolica del Sacro Cuore, Istituto di Radiologia, Roma, Italy; ¹⁶Università Cattolica del Sacro Cuore, Istituto di Radiologia, Roma, Italy; ¹⁷Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Roma, Italy

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Purpose or Objective

This retrospective, multicenter study analyzes the efficacy and safety of stereotactic body radiotherapy in a large cohort of patients with oligometastatic/persistent/recurrent uterine cancer.

Material and Methods

A standardized data collection from several radiotherapy centres that treated patients by stereotactic body radiotherapy between March 2006 and February 2022 was set up. Clinical and stereotactic body radiotherapy parameters were collected. The objective response rate was defined as a composite of complete and partial response, while clinical benefit included objective response rate plus stable disease. Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Common Terminology Criteria for Adverse Events scales were used to grade toxicities. The primary endpoints were the rate of complete response to stereotactic body radiotherapy, and the 2-year actuarial local control rate on a 'per lesion' basis. The secondary endpoints were progression-free survival and overall survival, as well as toxicity.

Results

A total of 157 patients with oligometastatic/persistent/recurrent uterine cancer-bearing 272 lesions treated by stereotactic body radiotherapy at 14 different centers were selected for analysis. Of the sites of metastatic disease, lymph node metastases (137, 50.4%) were most common, followed by parenchyma lesions (135, 49.6%). The median total dose was 35 Gy (range 10-75.2), in five fractions (range 1-10). Complete and partial responses were found in 174 (64.0%), and 54 (19.9%), respectively. Stable disease was registered in 29(10.6%), while 15 (5.5%) lesions progressed. Patients achieving complete response on a 'per lesion' basis experienced a 2-year actuarial local control rate of 92.4% versus 33.5% in lesions not achieving complete response (p<0.001). There was not a statistically significative difference in terms of actuarial local control rate between nodal and parenchymal lesions. There were 58 acute toxicities reported, the most of which were minor (Grade 1 and Grade 2), and four of which were severe (two Grade 3 pain, one Grade 4 pain, and one toxic death due to gastric perforation).

Conclusion

Our analysis confirmed the efficacy of stereotactic body radiotherapy in oligometastatic/persistent/recurrent uterine cancer patients. The low toxicity profile and the high local control rate in complete responder patients encourage the wider use of stereotactic body radiotherapy in this setting.