6th ICHNO Abstract Book

page 40 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ Material and Methods 6th ICHNO

the control rates according to the stage of disease and T size classification are mentioned in Table 1. The rate of local recurrence was 8.62%, Regional Recurrence was 1.72%, Loco-Regional Failure was 3.44% and Distant metastases following local or regional failure was 17.23%. The Median BED for α/β =10 was 86.775Gy and DFS was 74.07% in patients receiving more than 86.775Gy and DFS was 64.82% in patients receiving less than 86.775Gy and Median BED for α/β =3 was 128.76Gy and DFS was 74.07 in patients receiving more than 128.76Gy as compared to 64.82% in patients receiving less than 128.76Gy. The median EQD2 for α/β =10 was 71.6Gy and for α/β =3 was 75.85Gy. The DFS was 75.86% in patients receiving more than median dose of 71.6Gy compared to 61.53% in those receiving less than the median dose. The DFS was 78.57% in patients receiving median dose of 75.85Gy as compared to 59.26% in those receiving less than the median dose. Conclusion The overall outcome in the Patients with oral cavity and oropharyngeal malignancies was good with implementing of HDR – Interstitial Brachytherapy and use of Angiocatheters as carriers of Iridium – 192 wire. The BED10 value of 86.775Gy and BED3 of 128.76Gy showed that the dose received more than the median showed better outcomes in the form of DFS. The EQD2 calculated values suggested the dose received more than 71.6Gy (α/β =10) and 75.85Gy (α/β =3) showed better outcomes .The role of HDR Interstitial Brachytherapy in Head and Neck cancers is a proven, effective and safe treatment method with excellent long term outcome. PO-085 Role of L Glutamine in reducing severity of chemoradiation induced mucositis and improve QoL in HNC V. Pareek 1 , R. Bhalavat 2 , M. Chandra 2 1 Jupiter Hospital- Thane, Radiation Oncology, Mumbai, India 2 Jupiter Hospital, Radiation Oncology, Thane, India Purpose or Objective The incidence of mucositis in the oral cavity, pharynx and larynx is high among patients with head and neck cancer (HNC) receiving chemo-radiotherapy (CRT), resulting in significant pain and impairment of quality of life. The present study investigated whether L-glutamine (glutamine) decreases the severity of mucositis in the oral cavity, pharynx and larynx induced by CRT Material and Methods Patients were randomized to orally receive either glutamine or placebo at a dose of 10 g 3 times a day throughout the CRT course. Mucositis was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. The primary end point was mucositis severity. Seventy biopsy proven patients with head and neck cancer receiving primary or adjuvant radiation therapy were randomized to receive either oral glutamine suspension daily 2h before radiation in the study arm (10 g in 1000 ml of water) ( n = 35) or placebo before radiation; control arm ( n = 35) Results Total 30 patients in the glutamine arm and total 33 patients in placebo developed mucositis. Grade 3 mucositis and grade 4 mucositis in the study arm (who received oral glutamine) were significantly less in the glutamine arm. The mean duration of grade 3 or worse mucositis (grade 3 and grade 4) was significantly less in study arm with P < 0.001. Mean time of onset of mucositis was significantly delayed in patients who took glutamine in comparison to control arm with P < 0.001. Overall, glutamine was associated with a significant reduction of mucositis, WL, and enteral nutrition. Conclusion

The study concerned three patients with nasopharyngeal carcinoma stage N2-3. A first CT dosimetry was performed for treatment planning using a 3D conformal radiotherapy. A second CT scan was acquired at 38-40 Gy. After merging the two scans, we quantified the anatomic variations in target volumes and organs at risk, and then we faithfully reproduce the original planned parameters on the new CT to assess the dosimetric changes and check constraints to organs at risk. A new treatment plan was generated based on the new target volumes and organs at risk. The new dose distribution and new dose-volume histograms were calculated and compared to the reference plane. Results The average reduction in lymph node and tumor macroscopic volumes (GTV) after 38-40 Gy was 53% and 40% respectively. Dosimetric coverage of planned target volume (PTV) and lymph node tumor remained satisfactory. To organs at risk, we found an increase of the maximum dose to the spinal cord for the three patients (1.4 Gy on average) and brainstem (1.5 Gy for a patient). After adaptation of the treatment plan, The coverage of PTVs remained satisfactory. For organs at risk, maximum doses to the spinal cord and brainstem decreased. On average, the decrease was about 1.15 Gy to the spinal cord and 6.85 Gy to the brain stem Conclusion Ours results demonstrated a dosimetric benefit with the use of adaptative radiotherapy in nasopharyngeal patients. This study should be continued with a greater number of patients to define a clear procedure especially that the application of this concept in clinical practice is limited due to the dependence on human resources. PO-084 HDR Interstitial Brachytherapy for head and neck malignancies with Iridium 192 implants V. Pareek 1 , R. Bhalavat 2 , M. Chandra 2 1 Jupiter Hospital- Thane, Radiation Oncology, Mumbai, India 2 Jupiter Hospital, Radiation Oncology, Thane, India Purpose or Objective To evaluate the treatment outcomes with HDR Interstitial Brachytherapy in Head and Neck Cancers at our Institute with use of Angiocatheters as carrier source of Iridium – 192 wire implants. Material and Methods 58 Patients with Head and Neck malignancies of varying TNM staging as per AJCC staging criteria were analyzed retrospectively between 2008 and 2015. 42 patients (72.41%) received EBRT with HDR – BRT and 26 patients (27.59%) received BRT alone. The age group ranged from 27 to 81 years (Median age 56 years) with 41 patients (70.69%) males and 17 patients (29.31%) females. HDR – BRT was delivered with Iridium – 192 wire implants using plastic bead techniques with varying dose rates. The Biological equivalent doses (BED) were calculated for both BRT and EBRT keeping α/β =10 for tumor and α/β =3 for normal tissue and subsequently median BED doses were calculated and similarly 2 Gy equivalent dose (EQD2) were calculated and loco-regional control and disease free survival was assessed. Results After completion of HDR – BRT, Patients for followed up one month later and subsequently every 3 months for first 2 years and thereafter every 6 months with median follow up period of 25 months (Range 2-84 months). The DFS probability at year 1 was 82.76% and 68.05% at year 7. The overall survival probability was 91.37% at year 1 and 85.89% at year 5. The local control rate was 67.27% and