ESTRO 2024 - Abstract Book

S1435

Clinical - Head & neck

ESTRO 2024

35(68.6%) (p=0.66). Feeding tube was required in 38(74.5%) vs. 36(70.6%) patients in standard and escalated dose arms (p=0.82). The median duration of feeding tube placement was 6 weeks in either arm. Hospitalization was needed by 17(33.3%) vs. 18(35.3%) (p=1.00) and the overall incidence of grade 4 toxicity was 17(33.3%) and 19(37.3%) in the standard and escalated dose arms (p=0.84). With a median follow-up of 39 months, there were 11 local failures, 10 regional failures, 16 distant metastases, and 48 deaths. The 2-year locoregional control rate was 85.4% for the entire cohort, 88.6% and 82.2% in the standard dose and escalated dose arms, respectively (p = 0.57) with a hazard ratio of 1.36 (95% CI 0.47 to 3.91). The 2-year DFS was 59.7% in the entire cohort, 64.7% and 54.8% in the standard dose and escalated dose arms, respectively (p=0.65) with a hazard ratio of 1.13 (95% CI 0.66 to 1.94). The 2-year OS was 67.3% in the entire cohort, and 68.2% and 66.6% in the standard dose and escalated dose arms respectively (p=0.99) with a hazard ratio of 1.00 (95% CI 0.57 to 1.76). The sitewise comparisons are shown in Table 1.

Standard dose arm

Escalated dose arm

p-value

All patients (n= 102)

2-yr Locoregional control

88.6%

82.2%

0.57

2-yr DFS

64.7%

54.8%

0.65

2-yr OS

68.2%

66.6%

0.99

Laryngeal/hypopharyngeal (n = 42)

2-yr Locoregional control

85.0%

88.4%

0.75

2-yr DFS

63.6%

60.0%

0.55

2-yr OS

68.2%

70.0%

0.83

Oropharyngeal (n = 60)

2-yr Locoregional control

91.7%

78.4%

0.37

2-yr DFS

65.5%

51.4%

0.99

2-yr OS

68.1%

64.4%

0.79

Conclusion:

Although feasible, 18FDG PET based dose escalation did not result in an improvement in local control, disease free or overall survival.

Keywords: dose escalation, laryngopharyngeal, non-inferior

References:

Maulik, Shaurav et al. “Definitive chemoradiation for oropharyngeal squamous carcinomas: Outcomes with intensity- modulated radiation therapy using simultaneous integrated boost, in a majorly p16 negative cohort.” Head & neck vol. 45,5 (2023): 1156-1161.