ESTRO 36 Abstract Book

S590 ESTRO 36 2017 _______________________________________________________________________________________________

Results Fifty patients (36 male and 14 female, mean age 61, range 14-82 years) were included. RT was post-operative in 22 patients (44.0%) and 25 (50.0%) patients received concurrent CT. At T0 evaluation, 32/50 patients (64.0%) were emotionally distressed (cut off value DT score≥4) and 12/50 patients (24%) showed anxiety/depression (cut off value HADS score≥14). No difference was observed according to previous surgery. During RT, patients who were distressed (32/50) or anxious and depressed (12/50) at the beginning of treatment did not show any significant variation of their DT score, while HADS score significantly improved at T2 evaluation (median HADS score 19 and 15, at T0 and T2 respectively, p=0.03). Patients who were not distressed (18/50) or anxious and depressed (38/50) at baseline, showed a worsening of DT score at both T1 (p=0.02) and T2 (p=0.01) as compared to baseline; HADS score remained substantially stable at T1 while worsened at T2 (p=0.03). At T1, 9/40 (22.5%) evaluable patients had G≥3 acute toxicity. Twenty seven/40 (67.5%) patients had significant emotional distress and 9/40 (22.5%) patients had significant anxiety and depression. Emotional distress was more frequently observed among patients who were also experiencing severe toxicity (77.7 versus 22.5% respectively, p<0.01). These patients were also more frequently anxious and depressed (55.5 versus 24.0% respectively, p=0.08). At T2, 10/34 (29.4%) evaluable patients had G≥3 acute toxicity. Twenty five/34 (73.5%) patients had significant emotional distress and 12/34 (35.3%) patients had significant anxiety and depression. No significant difference was observed according to severe toxicity Patients with H&N cancer frequently experience emotional distress and side effects of radiotherapy are stressful and anxiety provoking events. Beside adequate medical support, these patients also require focused psychological interventions. EP-1081 Tumor response after palliative radiotherapy in head and neck cancer and its influence on survival M. Cruz 1 , C. Sousa 1 , D. Branco 1 , L. Khouri 1 , J. Brandão 1 , G. Melo 1 1 Instituto Português de Oncologia de Coimbra, Radiation Oncology, Coimbra, Portugal Purpose or Objective The aim of this study is to evaluate tumor response in Head and Neck (H&N) cancer patients who underwent different fractionation schemes of palliative radiotherapy (RT) and its influence on overall survival. Material and Methods This is a retrospective unicentre study including patients diagnosed with H&N cancer not suitable for curative treatment. Those patients completed palliative radiotherapy to primary local-regional sites in our department between January 2013 and December 2015. Radiation therapy was delivered using a mega-voltage linear accelerator with 6 MV photons. Target volumes generally included the gross tumor volume with 1 to 2 cm margins. Tumor response patterns were evaluated following a cervical and chest Computed Tomography (CT) performed 4-6 weeks after RT. Results 53 patients were included in this study (73.4% male). Mean age was 71.3 years (±1.2). Primary tumor was localized in oropharynx in 34% of the patients, oral cavity in 20.7% and larynx in 18.9% of the patients. 92.4% of the tumors were histologically classified as squamous cells carcinoma. At the time of the diagnosis, 86.8% of the patients had stage IV disease. Mean Karnofksy Performance Status (KPS) was 68%. occurrence. Conclusion

RT palliative schemes chosen were 50Gy delivered in 20 fractions during 4 weeks (50Gy/20fr/4w) in 35% of our patients, 30Gy/10fr/2w in 32%, 37.5Gy/15fr/3w in 18.9% and 40Gy/20fr/4w in 13.2% of our patients. After the analysis of cervical and chest CT, 61.2% of the patients had partial response while 10.2% had complete imagiologic response, 18.4% had imagiologic progression and 8.2% had stabilised disease. After a mean follow-up period of 27.2 months (±8,3), overall survival was 9.55 months (±9,3). The group with better tumor response on CT was the group that underwent for the 50Gy/20fr/4w scheme (in which 89.4% had partial/complete response) with no need for interruption of the treatment due to toxicity. The group with longer overall survival was the group that underwent for the 30Gy/10fr/2w (11.8 months) and the shortest overall survival was verified after the 37.5Gy/15fr/3w scheme (5.2 months). Despite these results, there were no statistically significant differences between the four RT schemes delivered to our patients and overall survival (p=0.41). Patients who had better tumor response on CT (partial or complete response) had longer overall survival comparing to patients who had stabilised disease or progression (11.6 months vs. 6.65 months; p=0,011).

Conclusion There is no consensus regarding the choice of the optimal RT fractionation scheme used in palliative care of H&N cancer patients and careful patient selection. Patients with advanced incurable H&N cancer have a poor prognosis but the addition of palliative RT provides better local-regional control of the disease with the possibility of longer survival rates. More studies should be carried out in order to evaluate predictive factors of tumor response as a mean of improving patient’s outcomes and quality of life. EP-1082 Primary surgery vs. radiotherapy in early- stage oropharyngeal cancer: a single centre experience C. Pedro 1 , B. Mira 2 , P. Silva 1 , E. Netto 3 , R. Pocinho 1 , A. Mota 1 , P. Pereira 1 , M. Ferreira 2 , T. Alexandre 2 , I. Sargento 2 , P. Montalvão 4 , M. Magalhães 4 , S. Esteves 5 , F. Santos 1 1 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Radiotherapy Department, Lisboa, Portugal 2 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Oncology Department, Lisboa, Portugal 3 NOVA Medical School UNL, Radiation Oncology, Lisboa, Portugal 4 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Otorhinolaryngology Department, Lisboa, Portugal 5 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Clinical Research Unit, Lisboa, Portugal

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