ESTRO 2025 - Abstract Book

S998

Clinical – Head & neck

ESTRO 2025

1 Radiation Oncology, Radboudumc, Nijmegen, Netherlands. 2 Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands. 3 Radiation Oncology (Maastro), Maastricht University, Maastricht, Netherlands. 4 Radiation Oncology, Radboudumc, Arnhem, Netherlands. 5 Radiation Oncology, Amsterdam UMC, Amsterdam, Netherlands. 6 Medical Imaging, Radboudumc, Nijmegen, Netherlands Purpose/Objective: Xerostomia is one of the most common side effects after definitive (chemo)radiotherapy for head and neck cancer (HNC) and is notoriously known to negatively affect quality of life (QoL) on the long-term. A reduced salivary flow is likely to have more consequences than the sensation of a dry mouth only as the functions of saliva are multifarious. The aim of this study was to investigate consequential QoL sequelae of radiation-induced xerostomia in HNC patients. Material/Methods: In the multicenter randomized controlled UPGRADE-RT trial (NCT02442375), 300 newly diagnosed cT 2-4 N 0-2 M 0 HNC patients were accrued in 5 Dutch centers and were randomized in a ratio of 1:2 to receive definitive radiotherapy (68 Gy in 34 fractions in 5.5 weeks) with standard (50 Gy) or reduced (43 Gy) elective radiation dose to the neck [1]. At baseline, 3, 6, 12 and 24 months after treatment, QoL was assessed using the EORTC QLQ-H&N35 and SWAL-QOL questionnaires. In this post-hoc analysis, questionnaires were analyzed using a linear mixed effects model. Based on the QLQ-H&N35 dry mouth item, two groups were compared (no-mild versus moderate-severe xerostomia at 3 months). Results: Between July 28, 2016 and January 25, 2022, 300 patients were randomized. Assessments of the QLQ-H&N35 and SWAL-QOL were available over a 2-year follow-up for 89.1% (1387 of 1236 expected) and 90.0% (1214 of 1348 expected), respectively. For this analysis, data was available for 260 patients of which 50% (131/260) and 50% (129/260) had moderate-severe and no-mild xerostomia at 3 months, respectively. For patients with moderate-severe xerostomia at 3 months, there was a significant improvement of dry-mouth symptoms until 12 months after treatment (Figure 1). Consequential QoL sequelae resulting from hyposalivation were slow eating and food sticking in throat but also poor sleeping and tiredness (Figure 2). No marked improvements of the consequential QoL sequelae were observed during time and remained significantly different between groups until 2-year follow-up.