ESTRO 2024 - Abstract Book

S1434

Clinical - Head & neck

ESTRO 2024

References:

1. Butterworth C, McCaul L, Barclay C. Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol, 2016; 130(S2):S41-S44

2. Aarup-Kristensen S, Hansen CR, Forner L, Brink C, Eriksen JG, Johansen J. Osteoradionecrosis of the mandible after radiotherapy for head and neck cancer: Risk factors and dose-volume correlations. Acta Oncol. 2019; 58(10): 1373-1377

2902

Proffered Paper

Dose escalation in high risk laryngopharyngeal cancers: Results of the INTELHOPE study(NCT02757222)

Sanjoy Chatterjee, Indranil Mallick, Jyoti O Sharma, Balakrishnan Arun, Sriram Prasath, Pattatheyil Arun

Tata medical center, Radiation oncology, Kolkata, India

Purpose/Objective:

Concurrent cisplatin and radiation to high risk laryngopharyngeal cancers have poor outcomes. We report the results of a Phase II randomized study comparing standard versus FDG-PET guided escalated dose in p16 negative oropharyngeal (OP) or locally advanced laryngopharyngeal (LP) cancers.

Material/Methods:

Between 2016- 2021, 102 patients with high risk squamous cell carcinomas of OP as reported by Ang et al. and with locally advanced LH were included. In the escalated arm ( 73.5Gy/30 fractions), subvolume BTV-PET was defined as 5mm isotropic margin on the SUV40%max isocontour compared to 66 Gy/30 Fractions to high risk CTV as standard arm. Both arms received concurrent cisplatin-based chemotherapy at 40mg/m2 weekly. The primary endpoint was grade 4 acute toxicity(CTCAE v4.0). Secondary outcomes were 2-year locoregional recurrence, disease free survival (DFS) and overall survival (OS).

Results:

One hundred and two patients (42 LP primaries and 60 OP) were recruited, 51 each were randomized to the escalated and standard arms. All patients received a planning FDG PET CT. Patients were mandated to meet the prespecified dose volume parameters. Median age was 59 years (range 30 to 73), with 72.5% T3/4 primaries and 58.8% N2-3 nodal stage . All plans met the prespecified dosimetric constraints. Both arms received a median of 5 concurrent cisplatin chemotherapy cycles.

The incidence of acute grade 3 toxicities was not significantly different between standard and escalated dose arms: mucositis 18(35.3%) in both arms (p=1.00); dermatitis 4(7.8%) vs. 2(3.9%) (p=0.67); dysphagia 38(74.5%) vs.