ESTRO 2024 - Abstract Book

S1201

Clinical - Head & neck

ESTRO 2024

Conclusion:

Dose escalation for palliation in HNSCC did not improve progression free survival or overall survival.

Keywords: Phase III, Trail, Palliative, Radiation

483

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Clinical outcomes after dose painting of head and neck cancer with poor prognosis

Einar Dale 1 , Morten E Evensen 2 , Cecilie D Amdal 1 , Torbjørn Furre 3 , Ayca M Løndalen 4 , Taran P Hellebust 3,5 , Hanne A Eide 1 , Åse Bratland 1 , Eirik Malinen 6,5 1 Oslo University Hospital, Department of Oncology, Oslo, Norway. 2 Drammen Hospital, Section of Oncology, Drammen, Norway. 3 Oslo University Hospital, Department of Medical Physics, Oslo, Norway. 4 Oslo University Hospital, Department of Radiology and Nuclear Medicine, Oslo, Norway. 5 University of Oslo, Department of Physics, Oslo, Norway. 6 Oslo University Hospital, Department of Radiation Biology, Oslo, Norway

Purpose/Objective:

Dose painting have the potential to increase loco-regional control in head and neck cancer (HNC) without added morbidity. Dose painting may be especially effective for HNC patients with a poor prognosis. Here, we present the clinical outcome of two phase I studies on dose painting using FDG-PET/CT guided dose painting by contours (DPBC).

Material/Methods:

Primary radiotherapy for HNC in Norway is given with a total dose of 68 Gy with 2 Gy per fraction, 6 fractions per week. For three-level DPBC, we defined two prescription volumes (PV) in addition to CTV; PV33 and PV66, corresponding to 33% and 66% of the highest FDG uptake in the tumor, respectively. The CTV prescription dose was 68 Gy, PV33; 73.1 Gy and PV66; 78.2 Gy and Dmax 83.3 Gy. We performed two phase 1 trials (RADPAINT-1; NCT03847480 and RADPAINT-2; NCT04910308). Important inclusion criteria were patients with HPV-unrelated HNC and HPV-related HNC with large (T4) tumors. The primary endpoint (CTCAE v4.0) was late toxicity - mucosal ulcer one year after treatment. Secondary endpoints were disease control measures. In addition to the routine follow-up, the participants were evaluated with respect to toxicity at 6 weeks, 6 months, 1 year, 1.5 years and 3 years after radiotherapy.

Results: