6th ICHNO Abstract Book

page 60 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ Purpose or Objective 6th ICHNO

Material and Methods During March 2016, clinical staff from radiotherapy centres across the UK and Ireland, involved in the consent process for Head and Neck Radiotherapy (HNRT), completed an e-mail survey about their current consent practice for HNRT. They were asked to tick, from a list of 14, which RTLE they would routinely discuss with a patient who had a T3N2bM0 squamous cell carcinoma of the oropharynx, and who was due to undergo curative radiotherapy. They were also asked to list any other RTLE for which they would routinely consent, which were not on the list. They were also asked about their process for monitoring and support of RTLE during follow-up. Results Responses were received from 53 clinical staff. The median number of RTLE discussed with patients was 9. The range was between 2 and 14. Table 1 shows the RTLE and the frequency with which they are discussed at consent. 16.6% of clinical staff prospectively score RTLE in clinic during follow-up ; 61.1% only document if there is a RTLE- related problem mentioned in clinic. 81.5% of clinical staff measure thyroid function only if symptoms of hypothyroidism are mentioned. 42% of clinical staff did not know if their patients are still feeding tube dependent at one year. 18.2% of clinical staff have access to a dedicated RTLE clinic service.

Melatonin (N-acetyl-5-methoxytryptamine) is a potent free radical scavenger with anti-oxidative and anti- inflammatory properties. It reportedly maintains mitochondrial homeostasis under various pathophysiological conditions, including radiation injury. We recently found that a melatonin oral gel at 3% restored melatonin levels in the tongue and prevented mucosal disruption and ulcer formation caused by irradiation due to its anti-inflammatory properties. Melatonin oral gel protected the mitochondria from radiation damage and blunts inflammasome signal activation in the tongue. The objective of this study was to analyse several melatonin formulations to prevent oral mucositis and gastrointestinal damage in radiation-induced mucositis model in rat. Material and Methods Male Wistar rats were subjected to irradiation. The radiation was administered using a Ray-X YXLON Y.Tu 320- D03 irradiator, and the rats received a dose of 7.5 Gy/day for 5 days in their oral cavity. Irradiated rats were treated during 19 days T.I.D. with different melatonin formulations. During the study, local effects were controlled, tongue and duodenum were analysed and melatonin levels were also evaluated in tongue and We demonstrated that treatment with 3% melatonin selected gel protected rats from oral mucositis after irradiation, also protected duodenum against inflammation and necrosis, and restored endogenous local melatonin levels in irradiated animals. Conclusion The formulation of melatonin oral gel, chosen for preclinical and clinical development, showed the highest efficacy preventing oral mucositis and gut damage in irradiated rats. The selected melatonin gel formulation also showed the highest local absorption, restoring endogenous melatonin levels, and the lowest systemic absorption after repeated oral administration. These results have led to a clinical trial (Nº EudraCT: 2015- 001534-13) PO-126 Consenting patients for late-effects of head and neck radiotherapy: an audit of UK oncology practice J.A. Christian 1 , J. Fenwick 2 , B. Foran 3 1 Nottingham University Hospital- Nottingham, Department of Clinical Oncology- City Campus, Nottingham, United Kingdom 2 Merck Serono an affiliate of Merck KGaA- Darmstadt- Germany, an affiliate of Merck KGaA- Darmstadt- Germany, Feltham-, United Kingdom 3 Weston Park Hospital, Department of Oncology, Sheffield, United Kingdom Purpose or Objective Long-term morbidity after the curative treatment of head and neck cancer is well-recognised as a significant issue, but for many patients and clinical staff it can be seen as a ‘secondary problem’ to face only once they have got over the major hurdle of their cancer being cured. Because late complications of treatment may occur many years after curative cancer treatment, it can be a neglected area at the time of primary consent especially when patients are faced with the often over-whelming package of immediate cancer treatment that is facing them. It can then remain a neglected area during follow-up. This survey investigates the extent to which Radiotherapy Late Effects (RTLE) are routinely discussed during the consent process, prior to commencing curative treatment for Head and Neck cancer. plasma. Results

Conclusion There is a wide variation across UK radiotherapy centres in what is discussed with patients concerning RTLE prior to curative treatment with radiotherapy. With increasing emphasis on survivorship, RTLE must have a higher priority not only in our pre-treatment discussions but more intentional follow-up processes are needed where RTLE are easily identified and support given.