ESTRO 36 Abstract Book

S318 ESTRO 36 _______________________________________________________________________________________________

than men (p< 0.001) and patients presenting nasal cavity tumors scored higher that all other tumoral sites (p=0.08). Conclusion HNC patients undergoing radiation therapy have high levels of emotional distress, anxiety and claustrophobia. Given the high percentage of psychological distress, awareness and management of these issues are primordial as they may have significant impact on treatment acceptance and tolerability as well QOL during and after treatment. PO-0609 18F-FDG-PET in Guiding Dose-painting with IMRT in Oropharyngeal Tumours (FiGaRO) – Early Results A. Michaelidou 1 , L. Pike 2 , C. Thomas 3 , L. Penketh 4 , Y. Suh 5 , S. Barrington 2 , M. Evans 4 , M. Lei 1 , T. Guerrero Urbano 1 1 Guy's and St Thomas' NHS Foundation Trust, Clinical Oncology, London, United Kingdom 2 The PET Centre at St Thomas' Hospital, Nuclear Medicine, London, United Kingdom 3 Guy's and St Thomas' NHS Foundation Trust, Radiotherapy Physics, London, United Kingdom 4 Velindre Cancer Centre, Clinical Oncology, Cardiff, United Kingdom 5 Royal Marsden NHS Foundation Trust, Clinical Oncology, London, United Kingdom Purpose or Objective IMRT ± chemotherapy is an effective treatment for stage III/IVa oropharyngeal squamous cell carcinoma (SCC). Treatment failures occur mostly at the primary site and are difficult to salvage. Dose escalation strategies are being explored, with target volume definition and toxicity considered the main challenges. IMRT can boost doses to selected areas (dose painting) without exceeding normal tissue tolerances. 18 F-FDG-PET/CT can mediate this, by defining areas of metabolic activity for dose escalation. This Phase 1 multicentre study aims to test the feasibility and safety of 18 F-FDG-PET/CT dose-painted IMRT in locally advanced oropharyngeal SCC. We present toxicity results Patients with ≥T2, HPV-negative or high-risk HPV-positive disease, suitable for radical treatment with neo-adjuvant chemotherapy and chemo-IMRT, are eligible. PET/CT is acquired after one chemotherapy cycle, in the radiotherapy position, in the immobilization shell. The FDG-avid gross tumour volume (GTV-T 18 F-FDG-PET) is manually delineated by a nuclear medicine physician then copied onto the fused CT for direct planning. Thirty daily fractions are delivered in 6 weeks, at 3 dose levels. The radical volume (PTV1) receives 65Gy, the prophylactic volume (PTV2) 54Gy and the GTV-T 18 F-FDG-PET receives Fifteen patients (14 male, 1 female; mean age-61, range 49-71) were treated April’14-March’16, at two centres (median follow-up 10 months, range 4-26 months. Eight (53.3%) are HPV-negative, 7(46.7%) are HPV-positive. Average GTV-T 18 F-FDG-PET volume was 11.9cc (range 1.6- 67.7cc). Target volume objectives were met in all (median D 95 98.1%, range 96.1-98.9%; Median D 5 102.9%, range 101.1-103.6%), whilst respecting normal tissue tolerances and PTV1 hotspot constraints. On the CTCAEv.4.0 scale, end of treatment toxicities were: Grade 4–none; Grade 3 - dysphagia-46.7%(n=7), mucositis-26.7%(n=4), pain-13.3%(n=2), salivary gland- 6.7% (n=1); Grade 2- dysphagia-53.3%(n=8), mucositis- 73.3%(n=11), pain-73.3%(n=11), salivary gland- 86.7%(n=13), dermatitis-73.3%(n=11), xerostomia- 66.7%(n=10), fatigue-46.7%(n=7). Three month post- treatment toxicities were: Grade 4–none; Grade 3 - dysphagia-20.0%(n=3); Grade 2- dysphagia-20.0%(n=3), mucositis-13.3%(n=2), pain-20.0%(n=3), xerostomia- 53.3%(n=8). in the first 15 patients. Material and Methods 71.5Gy. Results

On the RTOG/EORTC scale 3-month post treatment toxicities were: Grade 4-none; Grade 3-salivary gland- 6.7%(n=1), oesophagus-6.7%(n=1); Grade 2–salivary gland- 46.7%(n=7), oesophagus-13.3%(n=2), mucosa-13.3%(n=2), joint(TMJ)-6.7%(n=1). On LENTSOMA categories one patient had a grade 4 toxicity - oropharyngeal dysphagia (gastrostomy dependent). Six (40.0%) had grade 3 toxicities and 13 (86.7%) had grade 2 toxicities. There were 2 local recurrences within 1 year, both underwent salvage surgery with clear margins. Conclusion 18 F-FDG-PET-guided selective dose escalation is feasible, with acceptable acute toxicity. Late toxicity assessment (3, 6 and 12-months post-treatment) is ongoing. PO-0610 Effects of an oral health promotion program in head and neck cancer patients receiving radiotherapy E. Kim 1 , H.G. Wu 1 , J.H. Kim 1 , K.S. Kim 1 , T. Yu 1 , C.W. Wee 1 , N. Choi 1 , B.S. Jang 1 , S.H. Jeon 1 , H.J. Lee 2 , D.H. Han 2 1 Seoul National University College of Medicine, Radiation Oncology, Seoul, Korea Republic of 2 Seoul National University College of Dentistry, Preventive and Social Dentistry, Seoul, Korea Republic of Purpose or Objective To develop oral health promotion program and evaluate its effectiveness in head and neck cancer (HNC) patients receiving radiotherapy (RT). Material and Methods This was an open-label, non-randomized, prospective study in 84 HNC patients treated with RT. Dental health promotion program consisted of oral exam, oral health education, fluoride varnish and mouthwash. Forty-seven patients were assigned to an experimental group with the dental health care program and 37 to a control group. Clinical benefit was measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire head and neck module (QLQ-H&N35) and the oral examination before and up to 6 months after RT. Results Compared with the control group, the experimental group showed significant improvement in sexuality, use of pain killers, and worried about future (p = 0.045, p = 0.049, and p < 0.001, respectively). Oral health promotion program did not affect the development of xerostomia. Subgroups of patients with old age (≥ 60 years), stage IV HNC, and radical RT reported significant improvement in quality of life by oral health promotion protocol. Although caries experience significantly increased in a control group (p = 0.002), there was no significant change in an experimental group. The experimental group showed significantly decreased plaque score and bleeding on probe (p < 0.001 and p = 0.004). Conclusion Administration of our oral health promotion program decreased dental problems and slightly improved patients’ quality of life. We recommend the dental care program for HNC patients receiving RT to reduce treatment related oral toxicities. PO-0611 Long-term prognostic impacts of pretreatment plasma EBV DNA status in nasopharyngeal carcinoma J.C. Lin 1 , W.Y. Wang 2 , J.W. Huang 1 1 Taichung Veterans General Hospital, Department of Radiation Oncology, Taichung, Taiwan 2 Hung Kuang University, Department of Nursing, Taichung, Taiwan Purpose or Objective To investigate the prognostic impacts of pretreatment plasma EBV (pEBV) DNA in patients with nasopharyngeal carcinoma.