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 79

Conclusion Routine involvement of an advanced wound care management team and early consideration for calcium alginate dressings in case of moist desquamation should be warranted to ensure high compliance to radiotherapy and cetuximab in patients with head and neck cancer PO-149 Impact of Palliative Quad Shot RT on psycho- social outcomes in locally advanced HNC in MLIC's R. Kanodia 1 , R. Kumar 1 , S. Bhasker 1 , A. Biswas 1 , H. Verma 2 , S. Chander 1 1 All India Institute of Medical Sciences AIIMS, Radiation Oncology, New Delhi, India; 2 All India Institute of Medical Sciences AIIMS, Otorhinolaryngology, New Delhi, India Purpose or Objective Locally advanced Head & neck cancer (LAHNC) is a major cancer burden in developing countries, especially in South Asia. In general, prognosis is poor with an estimated median survival of 6 months with the best of cancer care available today. Besides the physical functioning, HNC may have a profound effect on psychological & psycho- socio-emotional wellbeing & subsequently quality of life. Facial disfigurement including body image & intimacy issues apart from depression & anxiety may result in social isolation and a poor QOL. The aim of this study is to evaluate the psychological & socio-emotional outcomes on the quality of life in newly diagnosed locally advanced non-metastatic incurable head & neck cancer patients treated with palliative QUAD-SHOT Radiation therapy in MLIC’s. Material and Methods Total of 36 patients with Stage IV (AJCC – 7 th ) HNC were enrolled in this prospective, single arm pilot study from July 2016 to January 2018. Palliative QUAD SHOT RT regimen was designed to deliver 14 Gy in 4 fractions twice daily at least 6 hours apart on 2 consecutive days for up to 3 cycles given every 4 weekly till no disease progression. HRQOL including the psycho-social and emotional functioning was assessed at baseline, 3 and 6 months post initiation of QUAD-SHOT RT using the EORTC-QLQ-C30 & QLQ-Head and Neck 35 questionnaire. Results Median age of cohort was 52.5 yrs (Range: 30-72). Among them, majority were male (86.1%) & had an ECOG PS 2 (88.9%). Oral cavity cancers were most common (63.9%) followed by oropharynx (22.2%) & hypo-laryngopharynx (13.8%). Median duration of symptoms was 5 months. The various psychological and socio-emotional factors assessed were depression, anxiety, stress, irritability, worry, facial disfigurement, loss of sexual pleasure, social eating & social interaction among the few. Depression was among most reported symptoms (79.1). The mean baseline emotional functioning score was 65.74 (SD, 15.65) while scores at 3 and 6 months of response evaluation was 85.29 (SD, 10.83) and 88.54 (SD, 10.85) respectively. Similarly, the mean initial social functioning score was 84.72 (SD, 16.12) whereas it changed to 93.75 (SD, 12.4) after 6 months of QUAD-shot RT. Thus a trend of clinically meaningful improvement in mean emotional (65.74 to 88.54) and social functioning score (84.72 to 93.75) was seen post radiation treatment when compared at baseline & on interim evaluation. Moreover, there was significant mood elevation & decreased anxiety partly while hypo- sexuality with only marginal improvements post treatment.

Conclusion HNC affects every aspects of life including psychological and psycho-social dimensions. QUAD SHOT RT is a good alternative option in advanced HNC patients in MLIC’s. There is a need for early inception of holistic psychological support to these patients helping them develop coping & social skills and confidence during their limited survival