Po20

Purpose Over the past few years, the complexity of brachytherapy (BT) has increased and the practice patterns have shifted to distinguish high-volume centers as primary sites for these procedures. As a result, women with locally advanced cervical cancer (LACC) who are treated with external-beam radiotherapy (EBRT) at local centers, are now more likely to be referred to higher-volume centers for their final BT boost. In previous publications, the American Brachytherapy Society found that patients at high-volume centers are more likely to receive higher-quality care. Given these results, we were curious whether treatment outcomes differ if the whole course of treatment is given at a high volume site versus women who split radiation therapy between multiple centers. The purpose of this study was to compare the duration of treatment, recurrence, and survival between patients who received all radiotherapy (RT) at one center compared to those with split treatment. Materials and Methods Women with stage IB2-IVA cervical cancer evaluated for definitive RT, including EBRT and BT between 2010-2022 were included. All patients received their BT at the PI. Patients were grouped by location of EBRT, either at the PI or at an outside center. Patients were excluded if they had incomplete radiation therapy data, missing address/zip code, metastatic disease, or prior hysterectomy. Variables collected included demographics, disease and treatment characteristics, comorbidities, distance traveled to the PI, EBRT site, treatment duration, and survival status. Recurrence and survival analyses are limited to patients with at least one year of follow up. Univariate analysis was done using paired t-tests for continuous variables and chi-square for categorical. Results Of the 117 women included, 23 (19.7%) underwent EBRT at an outside location and are included in the split group. There was no significant difference between the two groups for age, disease characteristics, or comorbidities. The mean distance traveled to the PI was compared between groups and found to be statistically significant (p=0.002), with split-group patients traveling a mean of 66.1 miles and PI-only patients traveling an average of 41.3 miles. Likewise, the mean distance traveled to the EBRT site was statistically significant, with women in the split group traveling a mean of only 11.9 miles (p<0.001). The median time to completion of RT was statistically significant (51.5 days in the PI group vs. 57.0 in the split group, p=0.032). Of the 94 patients treated exclusively at the PI, 61 (64.9%) completed treatment within the recommended 56 days as opposed to 47.8% of the split RT patients (p=0.204). A total of 63 women have at least one year of follow-up (11 in split-group and 52 in PI-only). Of these women, 9.1% in the split group and 9.6% in the PI-only group had positive recurrence rates (p=1.000). Additionally, overall survival data were not significant; 82.7% of women in the PI-only group are reported to be alive without disease compared to 90.1% in the split group (p=1.000). Conclusions In this study, we observed similar outcomes between LACC patients who had split their RT and those who received both EBRT and BT at the same high-volume PI. While women who received RT at the PI exclusively had a shorter median duration of treatment, the median times for both groups were similar and within the 8-week guidelines. Survival and recurrence data were also similar, although limited by the sample size and limited follow-up. These results suggest that the volume of the EBRT center does not impact differences in treatment duration and survival when treated at the same site for BT. We will continue evaluating updated survival and recurrence data as well as comparing the volume of patients seen at tertiary centers and will have these results to present in June. Over the past few years, the complexity of brachytherapy (BT) has increased and the practice patterns have shifted to distinguish high-volume centers as primary sites for these procedures. As a result, women with locally advanced cervical cancer (LACC) who are treated with external-beam radiotherapy (EBRT) at local centers, are now more likely to be referred to higher-volume centers for their final BT boost. In previous publications, the American Brachytherapy Society found that patients at high-volume centers are more likely to receive higher-quality care. Given these results, we were curious whether treatment outcomes differ if the whole course of treatment is given at a high volume site versus women who split radiation therapy between multiple centers. The purpose of this study was to compare the duration of treatment, recurrence, and survival between patients who received all radiotherapy (RT) at one center compared to those with split treatment. Women with stage IB2-IVA cervical cancer evaluated for definitive RT, including EBRT and BT between 2010-2022 were included. All patients received their BT at the PI. Patients were grouped by location of EBRT, either at the PI or at an outside center. Patients were excluded if they had incomplete radiation therapy data, missing address/zip code, metastatic disease, or prior hysterectomy. Variables collected included demographics, disease and treatment characteristics, comorbidities, distance traveled to the PI, EBRT site, treatment duration, and survival status. Recurrence and survival analyses are limited to patients with at least one year of follow up. Univariate analysis was done using paired t-tests for continuous variables and chi-square for categorical. Of the 117 women included, 23 (19.7%) underwent EBRT at an outside location and are included in the split group. There was no significant difference between the two groups for age, disease characteristics, or comorbidities. The mean distance traveled to the PI was compared between groups and found to be statistically significant (p=0.002), with split-group patients traveling a mean of 66.1 miles and PI-only patients traveling an average of 41.3 miles. Likewise, the mean distance traveled to the EBRT site was statistically significant, with women in the split group traveling a mean of only 11.9 miles (p<0.001). The median time to completion of RT was statistically significant (51.5 days in the PI group vs. 57.0 in the split group, p=0.032). Of the 94 patients treated exclusively at the PI, 61 (64.9%) completed treatment within the recommended 56 days as opposed to 47.8% of the split RT patients (p=0.204). A total of 63 women have at least one year of follow-up (11 in split-group and 52 in PI-only). Of these women, 9.1% in the split group and 9.6% in the PI-only group had positive recurrence rates (p=1.000). Additionally, overall survival data were not significant; 82.7% of women in the PI-only group are reported to be alive without disease compared to 90.1% in the split group (p=1.000). In this study, we observed similar outcomes between LACC patients who had split their RT and those who received both EBRT and BT at the same high-volume PI. While women who received RT at the PI exclusively had a shorter median duration of treatment, the median times for both groups were similar and within the 8-week guidelines. Survival and recurrence data were also similar, although limited by the sample size and limited follow-up. These results suggest that the volume of the EBRT center does not impact differences in treatment duration and survival when treated at the same site for BT. We will continue evaluating updated survival and recurrence data as well as comparing the volume of patients seen at tertiary centers and will have these results to present in June.