6th ICHNO Abstract Book

6th ICHNO 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ page 37

L. Deantonio 1 , M. Paolini 1 , E. Puta 2 , E. Ferrara 1 , L. Vigna 3 , R. Matheoud 3 , G. Sacchetti 2 , M. Brambilla 3 , M. Krengli 1 1 University Hospital Maggiore della Carità, Radiotherapy, Novara, Italy 2 University Hospital Maggiore della Carità, Nuclear Medicine, Novara, Italy 3 University Hospital Maggiore della Carità, Medical Physics, Novara, Italy Purpose or Objective To evaluate the predictive significance of different descriptive parameters in head-and-neck cancer patients undergoing pretreatment [F18] FDG-PET imaging Material and Methods Thirty-eight head-and-neck cancer patients who underwent FDG-PET before a course of curative intent radiotherapy were retrospectively analyzed. FDG-PET imaging parameters included maximum (SUVmax), and mean (SUVmean) standard uptake values, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). We studied three threshold methods: the threshold of the 40% of the maximum uptake value (SUV40%), the threshold of the 50% of the maximum uptake value (SUV50%) and the adaptive threshold algorithm (ATA) implemented on the iTaRT workstation (Tecnologie Avanzate, Italy), this algorithm used specific calibration curves that depended on the lesion-to-background ratio (LB ratio) and on the amplitude of reconstruction smoothing filter (FWH). The correlation of SUV parameters with tumour characteristics, treatment response, and survival were analysed. Results Higher SUVmeanATA was associated to higher primary tumour staging (p= 0.04). SUV parameters resulted not predictive of tumour response. The TLG ATA was predictive of local recurrence (p = 0.04) and MTV ATA of overall survival (OS) (p= 0.04). SUVmax (ROC 0.8, p= 0.01) was predictive of 2-year DFS. Conclusion This study suggests that the baseline [18F]FDG-PET/CT parameters could predict recurrence risk and overall survival in head and neck cancer patients treated with chemoradiotherapy PO-077 Cisplatin or Carboplatin in locally advanced head and neck squamous cell carcinoma N. Bahie eldin 1 , N. Mosalem 1 1 Ain Shams University Hospital, clinical oncology, Cairo, Egypt Purpose or Objective This single center open labelled randomized controlled trial comparing concurrent chemoradiotherapy with weekly cisplatin versus weekly carboplatin in patients with locally advanced head and neck squamous cell carcinoma Material and Methods From march 2013 to december 2015 62 patients with locally advanced head and neck squamous cell carcinoma were randomized with 31 to cisplatin arm and 31 to carboplatin arm planned radiotherapy was the same in both groups all patients were evaluated for efficacy and toxicity according to the as treated principle Results With a median follow up of 6 months the acute non hematological toxicity in the form of renal toxicity was significant in cisplatin ARM ( p=0.03)and hematological toxicity in the form of neutropenia was Abstract submission: 6th ICHNO withdrawn

significant (p=0.001) xerostomia as late toxicity was significant in carboplatin ARM (p=0.004) the 2 years pfs was 10 months in cisplatin ARM and 6 months in carboplatin arm ( p=o.048) Conclusion We concluded that efficacy of weekly cisplatin is superior to weekly carboplatin as part of CCRT moreover the tolerability of weekly cisplatin regimen was acceptable in carboplatin arm

Poster: Innovative treatments

PO-078 The evaluation of the set-up differences between radiation therapists for head and neck patients E. Kara (Turkey), A. Yazici, B. Dirican, B. Boybas, M.A. Gunaydin, A. Kartal, M. Akmansu, A. Hicsonmez 1 Onko Ankara oncology center, Oncology Department, Ankara, Turkey 2 Gulhane education and research hospital, radiation oncology, Ankara, Turkey 3 Gazi university, radiation oncology, Ankara, Turkey Purpose or Objective The set-up accuracy is important in intensity modulated radiation therapy (IMRT) to avoid the geographical misses increasing the risk of recurrence. In radiation therapy the set-up errors in the therapeutic fields are determined by using portal imaging and cone beam computed tomography (CBCT). The images obtained during treatment are compared with the planning images to verify the treatment fields. In this study, we try to figure out the electronic portal images’ (EPI) evaluation differences between the therapists in the reference of CBCT. Material and Methods In this study, 62 EPI images belonging to 13 head & neck patients treated in our department were evaluated separately by 4 therapists as offline and the amount of shift in the center of fields were determined. CBCT taken at the same time with the EPI images were accepted as reference and the amount of shift in the center of fields were compared separately for each therapist with the results of EPI. Results According to our results, the amount of shift in the center of fields have changed between therapists with 0 mm to 9,4 mm in the reference of CBCT. The probability of shifting center of fields to be greater than 3 mm were %60 for the first therapist, %35 for second therapist , %63 third therapist and %50 fourth therapist. The probability of shifting center of fields to be greater than 5 mm were 24%, 8%, 27% and 14.5%, respectively. ANOVA (analysis of variance for repeated measures) test was applied to center shift values by using SPSS program and there was significant difference in the groups (sig. <0.05) and a significant difference between the groups (sig. <0.05). The degree of impact of the difference between the groups is defined as statistically large. Conclusion This study that we have performed on 13 patients and 62 fractions due to figure out the evaluation differences of EPI images between therapists have revealed the importance of CBCT imaging in IMRT plannings having high dose gradient. The usage of CBCT for the verification of treatment fields eliminates the differences in interpersonal evaluation. CBCT improve the set-up accuracy such that PTV expansion margin can be safely dropped. Therefore, CBCT should be the preferred imaging modality in IMRT planning. Our results suggest