ESTRO 36 Abstract Book

S571 ESTRO 36 2017 _______________________________________________________________________________________________

EP-1042 Olfactory neuroblastoma – 10-year experience with VMAT radiotherapy H. Ariyaratne 1 , A. Ward 1 , P. Bhudia 1 , V. Lund 2 , D. Carnell 1 1 University College London Hospital NHS Trust, Clinical Oncology, London, United Kingdom 2 Royal National Throat Nose and Ear Hospital, Professorial Unit, London, United Kingdom Purpose or Objective Olfactory neuroblastoma is an unusual head and neck tumour arising from neuroectodermal cells. Localized disease is best managed with combined modality treatment with surgery and radiotherapy. Treatment is challenging due to the location of tumours around the cribriform plate. The majority of previously reported series of patients were treated with conformal radiotherapy. We report our experience in using volumetric modulated arc treatment (VMAT) with concurrent chemotherapy, in the management of this tumour. Material and Methods We retrospectively reviewed the records of patients with olfactory neuroblastoma treated at University College London Hospital between Aug 2006 and June 2016. Patients were treated by a specialist sinonasal surgeon and clinical oncologist, in a tertiary referral centre. Radiotherapy was inverse-planned and delivered using Rapidarc TM VMAT. The planning constraints used included DMax 55 Gy for brainstem, and DMax 50 Gy for optic nerves and chiasm. A dose of 60 – 65 Gy in 30 fractions was delivered to the target volume. Induction chemotherapy was used for bulky disease. Concurrent platinum-based chemotherapy was administered to patients during radiotherapy. Acute toxicity was assessed using the CTCAE grading system. Kaplan-Meier survival analysis was used for the whole group. Results 17 patients treated with VMAT radiotherapy were included. The median follow-up of patients was 43 months. The median age was 57 years (range 22 – 75 years). 53% were male. The Kadish stage distribution was: 4 patients had stage A, 3 patients had stage B, 7 patients had stage C, and 3 patients stage D disease.13 patients had endoscopic surgery and 3 patients had open craniofacial resection. One patient had unresectable disease. The majority of patients received concurrent cisplatin chemotherapy. Even with inverse-planned treatment, radiotherapy constraints for the optic apparatus were not met in many patients, due to the proximity of organs at risk. There was no acute grade 3/4 toxicity, and no long-term visual or neurological toxicity during the period of follow-up. 5-year overall survival of patients in this series was 83%. Conclusion VMAT radiotherapy with concurrent chemotherapy for olfactory neuroblastoma is well-tolerated. Overall survival of patients with olfactory neuroblastoma is good after multi-modality treatment. EP-1043 Chemo-reirradiation with simultaneously integrated boost in patients with local recurrence of HNSCC A. Mikhaylov 1 , N. Vorobyov 1,2,3 , E. Sokolova 4 , G. Andreev 5 , A. Kalesnik 5 , A. Lyubinskiy 5 , M. Rukhlenko 6 , V. Sokurenko 7 1 Dr. Berezin Medical Center, Radiation Therapy, Saint- Petersburg, Russian Federation 2 Saint-Petersburg State University, Oncology department, Saint-Petersburg, Russian Federation 3 North-western State Medical University named after I.I.Mechnikov, Oncology department, Saint-Petersburg, Russian Federation 4 Dr. Berezin Medical Center, Oncology department, Saint-Petersburg, Russian Federation 5 Dr. Berezin Medical Center, Medical Physics

Conclusion Despite significance in the logistic regression, proportions of patients receiving over 40Gy to the spinal cord were low, and similar in both patient groups. Cisplatin did not increase risk of LS. Other factors may be important and our results suggest age and unilateral treatment may also be key factors, possibly due to axial dose gradient across the spinal cord. Further work will focus on relationships between dose gradient and LS risk, and whether metformin could be neuroprotective in head and neck cancer patients undergoing radical radiotherapy. EP-1041 The Preliminary Report of PG2 in Improving QoL of Pharyngeal Cancer Patients in Chemoradiotherapy H.M. Wang 1 , J.R. Lin 2 , C.H. Hsieh 1 , C.L. Hsu 1 , C.Y. Lin 3 , J.T.C. Chang 3 1 Chang Gung Memorial Hospital, Division of Medical Oncology- Department of Internal Medicine, Taoyuan, Taiwan 2 Chang Gung University, Clinical Informatics and Medical Statistics Research Center and Graduate Institute of Clinical Medicine, Taoyuan, Taiwan 3 Chang Gung Memorial Hospital, Department of Radiation Oncology, Taoyuan, Taiwan Purpose or Objective Concurrent chemoradiation (CCRT) is the current standard of care for patients with locally advanced squamous cell carcinoma (SCC) of head and neck. This therapy can interfere the basic functions, including eating and speech, and can have a profound effect on social interactions and psychological state. PG2 (PhytoHealth Corporation, Taiwan, ROC), extracted, isolated and purified from the root of Astragalus (Huang-Chi), is the first TFDA NDA- approved botanical new drug for alleviating cancer- related fatigue and for the treatment of low energy level, low WBC counts, deteriorated quality of life, and an impaired immune function among cancer patients undergoing chemotherapy. To investigate the effect of PG2 for the reduction of the toxicities and deteriorated quality of life (QoL) and even increase the compliance of CCRT among advanced pharyngeal or laryngeal SCC patients receiving CCRT, the double-blind, randomized and placebo controlled trial was conducted. Material and Methods Advanced pharyngeal or laryngeal SCC pati ents were recruited and randomly assigned to receive either CCRT with PUL regimen (cisplatin/tegafur plus uracil/leucovorin) plus 500 mg PG2 t.i.w by IV infusion or CCRT with PUL plus placebo (normal saline) t.iw by IV infusion. Results The study was early termination after 17 patients completed the study due to the development of new formulation of PG2. Among these patients, a noticeably higher proportion of patients in PG2 group did not exhibit predefined clinical significant deterioration in HN pain, appetite loss, social eating, feel ill, physical functioning, role functioning, insomnia, swallowing, nausea/vomiting, and pain domains of QoL assessment by EORTC-QLQ-C30 and HN35 compared to the Control group (HN pain: 100% vs. 29%; appetite loss: 60% vs. 0%; social eating: 60% vs. 0%; feel ill: 60% vs. 14%; physical functioning: 100% vs. 57%; role functioning: 80% vs. 43%, insomnia: 80% vs. 43%; swallowing: 60% vs. 29%, nausea/vomiting: 60% vs. 29%, and pain: 60% vs. 29%). No difference in tumor response, CCRT compliance, and adverse events was observed. Conclusion PG2 is safe and has the potential role as a complementary treatment to improve quality of life during CCRT for patients with advanced pharyngeal or laryngeal SCC.