Objectives To report on patterns of morbidity from the EMBRACE prospective study on MRI image-guided, adaptive brachytherapy in locally advanced cervical cancer, using a novel method to identify patients with LAte, PERsistent, Substantial treatment-related symptoms (LAPERS).

Methods EORTC QLQ-C30 + CX24 were analyzed in 657 patients out of 1416 patients within the EMBRACE study who had a valid baseline, 3 months’ assessment and at least 3 additional late follow-ups. A LAPERS event for an individual patient was defined when the median scoring over late follow-ups was “quite a bit” or “very much” (substantial symptoms). For organ-related symptoms baseline morbidity was taken into account by requiring the median to be worse than the minimum of baseline and 3 months scoring (treatment-related). In addition, crude incidences and median prevalence rates were calculated.

Results Median follow-up was 42 months (IQR 30–59). LAPERS, crude incidence and median prevalence rates of substantial symptoms are presented in table 1; and examples including prevalence rates in figure 1. LAPERS/crude incidence ratios lower than 0.1 indicate that <10% of symptomatic patients experience persisting substantial symptoms. LAPERS/median prevalence ratios close to 1 indicate that the proportion of patients experiencing substantial symptoms displayed in the prevalence over time are the same individual patients with persisting symptoms.

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Abstract 18 Figure 1

Conclusions LAPERS method provides complementary information to prevalence and incidence rates. LAPERS provides a more appropriate tool for a valid assessment of patients’ burden of substantial toxicity.