ESTRO 2025 - Abstract Book

S951

Clinical – Head & neck

ESTRO 2025

In conclusion, this study confirms the hypothesis that most (around 80 %) loco-regional failures following primary RT for HNSCC are related to the high-dose volume. This was found regardless of the method applied in the image based pattern of failure analysis, and for both local and regional failures. To overcome the issue of radioresistance in HNSCC, the focus should be on identifying biomarkers to identify patients with poorer prognosis. For those patients, hyperfractionated RT (+chemotherapy) could be an option to increase loco(-regional) control.

Keywords: Pattern of failure, meta-analysis

937

Digital Poster Acute kidney injury following radical chemo-radiotherapy for head and neck cancer: a review of practice at a tertiary oncology centre Leah Brooks 1 , James Price 1,2 , Kate Garcez 2 , Chris Hughes 2 , Lip Wai Lee 2 , Kathleen Mais 2 , Asha Pritchard 2 , David Thomson 1,2 1 Department of Medical Education, University of Manchester, Manchester, United Kingdom. 2 Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom Purpose/Objective: Radical radiotherapy (RT) with concurrent high-dose cisplatin chemotherapy (100mg/m 2 ) is a standard of care for patients with locally advanced squamous cell carcinoma of the head and neck (HNSCC). Cisplatin improves oncological outcomes but is associated with acute kidney injury (AKI) 1 . Our aims were to determine incidence of AKI at our centre and identify baseline factors associated with AKI. Material/Methods: A retrospective analysis of prospectively collected data. Eligibility criteria: patients with biopsy-proven, non metastatic HNSCC who received curative-intent radiotherapy with concurrent 3-weekly cisplatin (100mg/m 2 q3w) or weekly cisplatin or carboplatin (AUC 5-6 q3w) between February 2020 and July 2023. Baseline patient, treatment and cancer factors were recorded, along with serial serum creatinine values, and the need for inpatient admission. An AKI was defined as an increase in creatinine >1.5 times greater than baseline or a rise of >26 umol/l in 48 hours occurring between RT start and six weeks post-RT 2 . A multivariable logistic regression model was fitted to identify factors associated with AKI. Results: 569 patients were eligible (cisplatin; n = 410 [72%]; carboplatin, n = 159 [28%]). The median age was 58 years (IQR, 53 – 63 years), 75% were male, 65% had a smoking history, 17% a history of hypertension and 7% a history of diabetes. 198 patients (35%) developed AKI (stage I, n = 188 [95%]; stage II, n = 8 [4%] and stage III, n = 2 [1%]. 147 patients (26%) required hospital management for AKI management, 86 (15%) as a day-case patient and 61 (11%) as an inpatient. On multivariable logistic regression, hypertension (odds ratio [OR]: 2.52, 95% confidence interval [95% CI] 1.42-4.49), baseline nuclear-medicine glomerular filtration rate (NM-GFR; OR: 0.99, 95% CI 0.98-1.00), male gender (OR: 0.55, 95% CI 0.36-0.84) and cisplatin use (vs carboplatin; OR: 2.65, 95% CI 1.66-4.29) were significant predictors of AKI. Conclusion: In our centre, a sizeable minority of patients (35%) developed an AKI. Female sex, cisplatin use (vs carboplatin use), baseline NM-GFR and a history of hypertension increased the risk of AKI. As a result, this department has now changed from 3-weekly to weekly chemotherapy as standard for all HNSCC patients. Further work involves a re audit of AKI rates following this change and exploring the optimum management of hypertensive patients.