ESTRO 2024 - Abstract Book

S1234

Clinical - Head & neck

ESTRO 2024

Material/Methods:

The medical records of 12 patients treated with definitive (n=6; 50%) or postoperative (n=6; 50%) PBS-PT between 2010 and 2023 at the Paul Scherrer Institute were retrospectively reviewed.

Ten (83 %) patients received proton irradiation at diagnosis and two (17%) patients were re-irradiated for local progression occurring after photon (n=1; 50%) and proton (n=1, 50%) radiotherapy (dose range 66-70 Gy (RBE)). Seven (70%) and one (50%) of the former and latter patients received neoadjuvant chemotherapy respectively. Eight (80%) and two (100%) of the upfront irradiation and re-irradiation patients received concomitant chemotherapy, respectively. One (10%) patient who received irradiation at diagnosis received concurrent chemotherapy only. Radiation doses ranged from 70.0 to 74.0 Gy (RBE) (median, 72.8 Gy (RBE)) for upfront irradiation and from 66.0 to 72.0 Gy (RBE) (median, 69 Gy (RBE)) for re-irradiation. The median follow-up time for all patients was 37.1 months (range, 6 – 67), and for the living patients it was 36.1 months (range, 6 – 65).

Results:

The 2-year overall survival (OS), freedom from distant metastasis, disease progression and locoregional recurrence for upfront irradiation were 80%, 70%, 70%, and 90%, respectively.

One patients who received re-irradiation is alive with no evidence of disease during a 24-month follow-up after PBS PT, and another pre-irradiated patient progressed four months after the treatment with an out-of-field failure.

Acute grade 3 toxicities occurred in 3 (25%) patients. Late grade 3 toxicities were observed in 5 (41.6%) patients (maxillary necrosis, n=1; dental cavities, n=1; cataract, n=2; epistaxis, n=1). No grade 4-5 late toxicity was observed. No patients developed any vision loss or asymptomatic brain necrosis.

Conclusion:

Our findings suggest that PBS-PT is a safe and efficacious treatment option for patients with SNUC and demonstrates a favourable disease control rate with an acceptable toxicity profile.

Keywords: Proton therapy, SNUC

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