7th ICHNO Abstract book

7th ICHNO 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ page 71

quantitative and qualitative assessment of Dg. Our clinical data are potentially useful for future comparison. PO-134 Clinical and dosimetric predictors of oral mucositis in the treatment of head and neck cancer F. Arcadipane 1 , E. Olimpio 2 , R. Ragona 2 , S. Martini 2 , G.C. Iorio 2 , E. Gallio 3 , J. Di Muzio 2 , P. Franco 2 , U. Ricardi 2 1 Città della Salute e della Scienza, Oncology- Radiation Oncology, Torino, Italy ; 2 University of Turin, Department of Oncology- Radiation Oncology, Turin, Italy ; 3 Città della Salute e della Scienza, Department of Oncology- Radiation Oncology, Torino, Italy Purpose or Objective Head and neck cancer (HNC) patients are usually treated with a combination of chemotherapy (CT) and radiotherapy (RT), and thus are prone to a wide range of short and long-term side effects. The occurrence of oral mucositis (OM) in HNC patients treated with RT and/or CT is extremely frequent. OM has been proven to have consistent clinical importance since it can impair the patient's compliance to treatment and the outcomes. The aim of this prospective study was to identify the predictive value of dosimetric parameters and also to assess the clinical predictors of acute OM. Material and Methods A total of 41 HNC patients were administered with a series of questionnaires, regarding pain (VAS score), QoL and functional status (OMWQ-HN, FACT-HN). Both WHO and OMAS scores were employed to assess OM. In the dosimetric analysis, we accounted for the whole oral mucosa and its subsites: posterior wall of pharynx (PWP), palate, base of the tongue (BOT) and oral cavity (OC). (Tab.1) Planning target volumes were subtracted from each subsite. We also investigated smoking, alcohol intake, diabetes, hypertension, CT modalities as clinical predictors of OM. Dosimetric Parameters Palate BOT OC PWP Oral Mucosa

Conclusion In our prospective cohort, we observed a correlation between acute toxicity and pain, impairment in global health status and general QoL. We were also able to assess the predictive value of different dosimetric and clinical parameters for OM. Further studies will be required to understand the clinical relevance of these findings. These parameters should be further validated to be implemented in daily clinical practice to prevent severe OM's onset and improve outcomes and QoL. PO-135 Laryngeal Dose correlation with Voice changes in Head and Neck cancer patients treated by VMAT J. Mathew 1 , A. Mukherji 2 , S. Saxena 1 , P. Vedasoundaram 1 , A. Menon 1 , N. Vijayaraghavan 1 1 Jawaharlal Institute of Postgraduate Medical Education and Research, Department of Radiation On, Puducherry, India; 2 Yashoda Hospitals, Department of Radiation Oncology, Hyderabad, India Purpose or Objective To study the voice changes in head & neck cancer patients treated with radical radiation therapy by VMAT and correlate it with the laryngeal dose. Material and Methods 25 Patients diagnosed with head and neck squamous cell carcinomas were subjected to pre-treatment evaluation of voice. GRBAS scaling was done and Maximum Phonation Time (MPT) and Fundamental frequencies (F o ) were evaluated using VAGMI software & tele-laryngoscopy was done to assess laryngeal edema were treated to a dose of 66 Gy to the High Risk PTV with or without chemotherapy with Cisplatin 100mg/m 2 by Simultaneous Integrated Boost using VMAT (Volumetric modulated Arc therapy). The patients were followed up at 3 and 6 months post

37,72 [15,62] 56,43 [16,40] 78,65 [30,95] 64,70 [33,03] 37,04 [30,09] 28,63 [27,92]

53,28 [14,86] 60,63 [12,25] 90,73 [19,43] 86,00 [24,22] 77,14 [33,16] 72,37 [35,22]

53,87 [15,28] 42,50 [13,69]

43,90 [12,57]

Average Dose

61,54 [12,86] 61,45 [13,36]

65,90 [10,87]

D1cc (Gy)

94,23 [20,15] 87,70 [21,64]

87,56 [20,67]

V20

75,30 [23,78]

89,96 [24,27] 72,77 [26,44]

V30

75,74 [35,47] 45,96 [30,03]

50,69[25,75]

V45

42,97 [25,50]

69.71 [37,38] 38,53 [29,79]

V50

Table 1 Dosimetric Parameters; [SD]

Results Both the OMAS and PRO scores show a similar trend during treatment and follow-up. In our analysis patient's age (p=0,02), V30 (p=0,02) and V45 (p=0,03) of the oral mucosa minus target PTV, were found to be statistically related to OM. Dosimetric predictors were identified for other subsites as well. In the PWP Dmax is linked to Mean Mucositis Score (MMS) (p=0.023), Weighted Mean Mucositis Score (WMMS) (p=0.022) and Extent of Mucositis Score (EMS) (p=0.05); in the palate minus PTV Dmax is related to MMS (p=0.05), WMMS (p=0.05) and in the BOT minus PTV average dose is related to Worst Site Score (WSS) (p=0.05). (Fig.1) OM was found to be statistically related to induction CT (WMMS p=0.06 and WSS p=0.08) and concomitant CT (MMS p=0.07). Among patients with G3 OM 93,3% were administered concomitant CT while 6,7% had received no CT (p=0.07). (Fig.2)