ESTRO 2024 - Abstract Book

S1202

Clinical - Head & neck

ESTRO 2024

In total 17 patients were enrolled. The median age was 65 years (range 49-78) and 4 were female. Ten of the patients had oropharyngeal cancer (OPC), 3 oral cavity, 2 hypopharyngeal and 2 laryngeal cancers. There were 5 HPV-related (p16 positive or HPV positive) OPCs. One, 6, and 10 patients had stage II, III and IVa (UICC 8) disease, respectively. Twelve of the patients received concomitant chemotherapy, weekly cisplatin 40 mg/m2 and all patients received nimorazole (a hypoxic radiosensitizer). In the RADPAINT-1 trial (n=7), a patient on anticoagulant medication experienced life- threatening bleeding from the tumor. Consequently, the trial was terminated as ≥ 1 life -threating incidence was defined as a stopping rule. In RADPAINT-2 (n=10), anticoagulant medication was introduced as an exclusion criterion. None of the patients experienced bleeding and only one patient experienced late mucosal ulcer grade 3 (none with grade 3 mucosal ulcer in RADPAINT-1). Four out of 17 patients have experienced local recurrence including one with a loco-regional recurrence. There have been two isolated regional recurrences and one distant (pulmonary) recurrence (Figure).

Figure: Kaplan-Meier curves for local control (LC), disease-free survival (DFS) and overall survival (OS) with 95% confidence intervals.

Conclusion:

Three-level dose painting of primary, large head and neck cancers to a maximum dose of 83 Gy did not seem to increase toxicity compared with historical data from conventional radiotherapy. We propose to perform a multicenter randomized phase 2 trial with late toxicity as the primary endpoint.

Keywords: Dose painting, FDG-PET/CT

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A study comparing response for weekly v/s three weekly cisplatin in accelerated CRT for HNSCC