ESTRO 37 Abstract book

ESTRO 37

S357

Conclusion In the era of multimodality treatment for HNC, higher grades of toxicities are expected to affect both patients' quality of life and overall treatment time. We demonstrated that a standardized stepped-wedge nutritional protocol is applicable in daily clinical practice. Furthermore, it was possible to prevent severe WL in most (83%) of the patients in our cohort. Validation of our approach is warranted through prospective studies on larger cohorts; multinstitutional efforts are strongly encouraged to achieve consensus on nutritional intervention in this subset of pts. PO-0700 A phase I-II trial on palliative short course accelerated radiotherapy in advanced head and neck malignancies E. Farina 1,2 , F. Deodato 3 , G. Macchia 3 , L. Caravatta 4 , S. Cilla 5 , M. Ferro 3 , S. Cammelli 1 , M. Boccardi 3 , G. Siepe 1 , A. Zamagni 1 , V. Panni 1 , A. Veraldi 1 , M.A. Sumon 6 , A.F.M. Kamal Uddin 6 , T. Wondemagegnhu 7 , M. Buwenge 1 , G.P. Frezza 8 , A.G. Morganti 1 1 Radiation Oncology Center Department of Experimental Diagnostic and Specialty Medicine – DIMES, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy 2 Department of Radiation Oncology, CRO-IRCCS National Cancer Institute, Aviano, Italy 3 Radiotherapy Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II", Campobasso, Italy 4 Radiation Oncology Department, Università "G. D'Annunzio", Chieti, Italy 5 Medical Physics Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Campobasso, Italy 6 United Hospital Limited, Radiation Oncology Department, Gulsha- Dhaka, Bangladesh 7 Department of Radiotherapy, Black Lion Hospital, Addis- Ababa, Ethiopia 8 Radiation Oncology Unit, Bellaria Hospital, Bologna, Italy Purpose or Objective Purpose/Objective. To define the maximum tolerated dose (MTD) of a conformal SHort course Accelerated RadiatiON therapy (SHARON) and safety and efficacy of this treatment in patients with symptomatic advanced Material/ methods. A phase I trial in four dose-escalation steps was designed: 14 Gy (3.5 Gy fraction), 16 Gy (4 Gy fraction), 18 Gy (4.5 Gy fraction) and 20 Gy (5 Gy fraction). Treatment was delivered in 2 days with a twice daily fractionation and at least 8 hour interval. The dose limiting toxicity (DLT) was defined as any acute toxicity > Grade 3, according to RTOG scale. Moreover, the MTD was used to plan a phase II trial based on Simon’s two- stage design. Pain was recorded using a Visual Analogic Scale (VAS). Impact on Quality of Life (QoL) was evaluated according to CLAS scales. Results Results. A total of 48 patients were treated. The most frequent baseline symptoms were pain (66.6%), pain associated to dysphagia (16.7%), pain associated to bleeding (8.3%), bleeding (4.2%), and dysphagia (4.2%). In the phase I trial the 20 Gy dose level was determined to be the MTD, with 1 out of 6 patients showing Grade 3 acute mucositis. In the phase II trial the palliative response rate (complete plus partial) was 82.7% with a median duration of palliation of 3 months. Complete pain relief was achieved in 33.3% of patients. The overall response rate for pain was 81.5%. Conclusion Conclusion. Conformal short course radiotherapy in twice daily fractions and 2 consecutive days is well tolerated up to a total dose of 20 Gy and produces an encouraging rate of symptomatic response. A non-inferiority phase III trial head and neck cancer. Material and Methods

has been planned to compare this regimen with a standard palliative regimen (30 Gy in 10 daily fractions). PO-0701 Survival-weight health profile in advanced oral cavity cancer patients C.H. Lai 1 , W.C. Chen 2 1 Chang-Gung Memorial Hospital- Chiayi branch, Radiation Oncology, Chiayi Conuty, Taiwan 2 Chang-Gung Memorial Hospital- Chiayi branch, Radiation Oncology, Chiayi County, Taiwan Purpose or Objective This study was designed to estimate the life expectancy (LE), quality-adjusted life expectancy (QALE) and survival-weight psychometric scores (SWPS) in advanced oral cavity cancer patients. Material and Methods A sample of 2624 stage III-IVB oral cavity cancer patients diagnosed between January 1, 2007 and December 31, 2013 was collected from the cancer registry database in four branch hospitals of our hospital system for estimation of lifetime survival function. All patients were followed up until death or censored on December 31, 2014. To obtain the utility and psychometric score for estimation of LE, QALE and SWPS, 196 patients were measured with the Taiwanese version of the EuroQol instrument (EQ-5D) and the Taiwan Chinese versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and QLQ-H&N35 between October 1, 2013 and October 6, 2017. The LE of advanced oral cavity cancer patients was obtained using linear extrapolation of a logit-transformed curve and was adjusted by the corresponding quality of life function to calculate the QALE and SWPS. Results The mean age at diagnosis of the 2624 advanced oral cavity cancer patients was 52.1 years. The median duration from the beginning of radiotherapy to the date of completing questionnaires was 1.7 months (range, 0- 158.1 months). The average LE and QALE were estimated to be 8.8 years and 7.8 quality-adjusted life years (QALYs) for advanced oral cavity cancer patients and 27.6 years and 28.6 QALYs for the reference population, respectively. On average, the lifelong duration of pain and painkiller use were 3.4 years and 2.0 years. The lifelong duration of any impairment of swallowing, smell and taste were 8.5 years, 3.2 years and 3.7 years, respectively. The life long duration of dry mouth was 7.1 years. Furthermore, the lifelong duration of tube-feeding was 1.9 years. Conclusion This study offers more understandable information than the 5 year survival outcomes when communicating with patients or the general population regarding cancer risk and the impact of treatments on the quality of life. In the future, evaluating the robustness of comparative assessments for the outcome of advanced oral cavity cancer patients undergoing different treatment protocols will be possible. PO-0702 Impact of deformable MRI registration on GTV delineation for head and neck in clinical practice. A. Taylor 1 , R. Speight 2 , D. Bird 2 , M. Sen 3 , R. Prestwich 3 1 University of Leeds, School of Medicine, Leeds, United Kingdom 2 Leeds Teaching Hospitals NHS Trust, Department of Medical Physics and Engineering, Leeds, United Kingdom 3 Leeds Teaching Hospitals NHS Trust, Department of Clinical Oncology, Leeds, United Kingdom Purpose or Objective Accurate delineation of head and neck squamous cell carcinomas (HNSCC) is vital for radiotherapy. Co- registration of MRI to a planning computed tomography