ESTRO 2023 - Abstract Book

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ESTRO 2023

Currently, patients’ quality of life evaluation during cancer treatment occupies an important place as well as the assessment of oncological results. The objective of our study was to evaluate the evolution of patients’ social life during radio-chemotherapy for nasopharyngeal carcinoma (NPCs). Materials and Methods This is a prospective study that included 50 patients treated for NPC with induction chemotherapy followed by intensity modulated radiotherapy associated with concomitant chemotherapy (RCC). The median age was 49 years [23-78] with a sex ratio of 2.64. According to the 8th edition TNM classification, the majority of patients had a stage IVa tumor (30 patients: 58.8%). All patients completed quality of life questionnaires QLQ-C30 EORT before the start of CCR (T1), at mid-treatment (T2), and the end of treatment (T3). Social life impairment was assessed by 2 questions of the QLQ-C30: Q26 “Did your physical condition or your medical treatment bother you in your family life? and Q27 "Your physical condition or your medical treatment interfered with your social activities (e.g. dating friends, going to the cinema...)? ". Responses coded from 1 (not at all) to 5 (too much) were transformed into scores that varied between 0 (no alteration) and 100 (maximum alteration). The comparison of the scores was carried out by the test of Wilcoxon between T1 and T2; between T1 and T3 and between T2 and T3. Results The mean score for the social life impairment was 86.33 ± 21.2; 72.66 ± 32.9 and 65.99 ± 28.1 at T1, T2, and T3 respectively. This alteration was significant between T1 and T2 (p=0.01) as well as between T1 and T3 (p < 0.001). However, the difference was not significant between the T2 and the T3. Conclusion During CCR, social life impairment is mainly seen during the 1st phase of treatment and it remains stable between T2 and T3. It could be due to lifestyle changes imposed by treatment (distance from radiotherapy centers) and acute toxicities. Regular evaluation of treatment impact on patient's quality of life allows better support and thus a better adherence to the therapeutic protocol.

PO-1195 Should we delineate lacrimal gland during nasopharyngeal carcinoma radiotherapy?

F. Dhouib 1 , S. Zouari 1 , N. Fourati 1 , F. Ajengui 1 , M. Frikha 1 , L. Farhat 1 , W. Siala 1 , W. Mnejja 1 , J. Daoud 1

1 Habib Bourguiba University Hospital, Radiation oncology, Sfax, Tunisia

Purpose or Objective Radiation-induced ocular complications are frequent during head and neck radiotherapy (HNRT). Someone are benign and others can be very serious leading to vision loss The damage of lacrimal gland (LG) is one of the most underestimated complications in HNRT. The purpose of this study is to evaluate the cumulative doses in the LG during radiotherapy (RT) for nasopharyngeal carcinoma (NPC) with a clinical toxicities correlation. Materials and Methods This is a retrospective study analyzing the dosimetric plans of 50 patients with NPC (82% stage III and IVa) treated between august 2020 and June 2022. All patients received neoadjuvant chemotherapy then RT at a total dose of 69.96Gy in 33 daily fractions with concomitant weekly cisplatin. The treatment plan was carried out with volumetric modulated arc therapy for 27 patients and Intensity Modulated Radiation Therapy for 23 patients. The right LG (RLG) and the left one (LLG) were delineated separately and the following variables were recorded: maximum dose (Dmax), mean dose (Dmean), volume of the planning target volume (PTV), cranio-caudal distance between the PTV receiving a dose of 60 Gy (PTV60) and LG (d). Ocular toxicity was assessed using the RTOG radiation morbidity criteria. Clinical assessment was performed at the end of the RT sessions, 6 and 12 months later.

Results

The median of Dmax in the RLG and LLG was of 5.6Gy [2.6–38] and 6.2 [2.6-27] respectively. The median Dmean in the RLG and LLG was 3.6 Gy [2.2-14.8] and 3.8 Gy [2.2-12]. The mean PTV volume was of 320 cc. The mean “d” was of 12 mm [0 24] (table1).

Table 1: Data of the cumulative doses in the lacrimal glands:

After a median follow up of 17 moths, no patients had G3 or G4 ocular toxicities. Nine (18%) and 2 (4%) patients developed G1 and G2 dry eye respectively. For those patients, the mean PTV volume was of 412 cc [334-683], the mean “d” was of 7 mm [0-9] and tumors were classified as T3-T4 for six patients. However, Dmean were below to 25 Gy in all these cases. In addition, the Q3 of Dmax in the RLG and LLG was of 29.7Gy [6.6-38 Gy] and 17.8 Gy [4.5-27 Gy] respectively. The Q3 of Dmean in the RLG and LLG was 10.5 Gy [3.9-14.8 Gy] and 8.6 Gy [3.8-12.2 Gy].

Conclusion