ESTRO 2020 Abstract Book

S10 ESTRO 2020

RT + CTX (n = 24)

RT + CDDP (n = 27)

Measure

p

Poster Highlights: Poster highlights 1 CL: Head & Neck

Xerostomia ≥ G3

1 (4)

4 (15)

ns

Disgeusia, any grade No Yes

PH-0038 RT and concomitant CDDP vs cetuximab for head and neck cancer: long term outcomes of a randomized PH. II trial D. Tomasini 1 , M. Maddalo 2 , P. Borghetti 2 , R. Corvò 3 , P. Bonomo 4 , A. Petrucci 5 , F. Paiar 6 , L. Lastrucci 7 , M.L. Bonù 1 , D. Greco 2 , L. Costa 2 , L. Pegurri 2 , L. Triggiani 1 , L. Belgioia 3 , I. Desideri 4 , S. Grisanti 8 , M. Buglione 1 , S.M. Magrini 1 1 ASST Spedali Civili and University of Brescia, Radiation Oncology Department, Brescia, Italy ; 2 ASST Spedali Civili di Brescia, Radiation Oncology Department, Brescia, Italy ; 3 Ospedale Policlinico San Martino and University of Genova, Health Science Department DISSAL and Radiation Oncology, Genova, Italy ; 4 Azienda Ospedaliero Universitaria Careggi, Department of Radiation Oncology, Firenze, Italy ; 5 Pistoia Hospital, Azienda Unità Sanitaria Locale No. 3, Pistoia, Italy ; 6 Azienda Ospedaliera Universitaria Pisana and University of Pisa, Department of Radiation Oncology, Pisa, Italy ; 7 Azienda Unità Sanitaria Locale No. 8, S. Donato Hospital, Arezzo, Italy ; 8 ASST Spedali Civili di Brescia, Medical Oncology Department, Brescia, Italy Purpose or Objective D escribing long-term survival and toxicity outcomes of a multicenter randomized phase II trial comparing radiotherapy (RT) plus concomitant cisplatin (CDDP) or cetuximab (CTX) as first line treatment in locally advanced squamous cell carcinoma of head and neck (LASCCHN). Material and Methods Between January 2011 and August 2014, 70 patients were enrolled and randomized 1:1 to receive RT plus concomitant weekly CDDP (40 mg/m2) or CTX (250 mg/m2 plus a loading dose of 400 mg/m2). This updated series focuses primarily on late toxicities (graded by using CTCAE scale version 4.0) and long-terms outcomes of survival, evaluated in terms of local control (LC), overall survival (OS), cancer-specific survival (CSS) and metastasis free survival (MFS). A supplementary analysis based on HPV status was also performed. Results No statistically significant difference was found in terms of late effects (xerostomia, fibrosis, mucosal atrophy, weight loss) in the two treatment arms (table 1). For the whole population, in the CDDP arm and in the CTX arm, respectively, 5-year LC rates were 67% and 48%; 5-year MFS rates 83% and 97%; 5-years OS rates 61% and 52%: 5-year CSS rates 70% and 59%. For patients with HPV+ oropharyngeal carcinoma, all the survival outcomes were even poorer in the CTX arm vs the CDDP arm. None of these differences reached statistical significance.

14

(58)

15

(56)

ns

10 (42)

12 (44)

Fibrosis ≥ G3

5 (21)

5 (19)

ns

Mucosal atrophy, any grade No Yes Weight loss > 10%* No Yes

17

(71)

22

(81)

ns

7 (29)

5 (19)

18

(82)

18

(82)

ns

4 (18)

4 (18)

Weight

loss,

any

percentage* No Yes

7

(32)

6

(27)

ns

15 (68)

16 (73)

Table 1. All data are presented as No (%) unless otherwise indicated. Abbreviations: CDDP, cisplatin; CTX, cetuximab; ns, non significant; RT, radiotherapy. * Weight loss data were available only in 44 patients, 22 in the RT+CTX arm and 22 in the RT+CDDP arm. Conclusion L ong-term results of this trial are in line with current literature suggesting that RT + CTX is inferior to CDDP + RT for LASCCHN. However, CTX + RT might still play a role in properly selected LASCCHN (particularly in HPV negative), also according to recent translational studies. PH-0039 Impact of sarcopenia on survival and recurrence after radiotherapy for head and neck cancer S. Thureau 1 , L. Lebret 1 , S. Dandoy 1 , M. Ebran 1 , C. Gouley Toutain 2 , F. Guerault 1 , L. Lefebvre 1 , R. Mallet 1 , C. Moldovan 3 , O. Veresezan 1 , J. Lequesne 4 , R. Modzelewski 5 , F. Clatot 3 1 Center Henri Becquerel, Radiotherapy, Rouen, France ; 2 Center Henri Becquerel, Supportive Care, Rouen, France ; 3 Center Henri Becquerel, Medical Oncology, Rouen, France ; 4 Center Henri Becquerel, Clinical Research Unit, Rouen, France ; 5 Center Henri Becquerel, Medical Informatic, Rouen, France Purpose or Objective Sarcopenia is frequent at the diagnostic of head and neck squamous cell carcinoma (HNSCC). We aimed to assess the prognostic impact of sarcopenia on survival among patients treated by radiotherapy or radiochemotherapy for HNSCC. Material and Methods The monocentric NutriNeck study (NCT02900963) recruited all HNSCC patients between 2014 and 2018 treated by RT or RTCT in curative intent. Patients fed by enteral nutrition before RT initiation were excluded. Clinical and biological data, planned volumes and doses of treatment were collected at baseline. Daily evaluation of the weight and weekly clinical, biological and food intake evaluation were performed during RT/RTCT. In case of 2 kg weight loss under treatment, enteral feeding by tube was proposed. Complete treatment was defined as full planned RT doses without more than 3 days interruption, and full planned doses of cisplatin and cetuximab if indicated. Sarcopenia was determined by measure of skeletal muscles at the third lumbar vertebra on the planning CT-scan of radiotherapy. Sarcopenia was defined as SMI (Skeletal muscle index) less than 52.4cm²/m² for men and 38.5cm²/m² for women. Results Among the 257 HNSCC patients included, 120 (47%) were treated by RT and 137 (53%) by RTCT. The mean age was