ICHNO-ECHNO 2022 - Abstract Book

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ICHNO-ECHNO 2022

Varanasi, India; 5 Mahamana Pandit Madan Mohan Malviya Cancer Centre, Radiation Oncology, varanasi, India; 6 Mahamana Pandit Madan Mohan Malviya Cancer Centre, Medical Oncology, Varanasi, India; 7 Mahamana Pandit Madan Mohan Malviya Cancer Centre, Head and Neck Oncology, varanasi, India; 8 Mahamana Pandit Madan Mohan Malviya Cancer Centre, Speech and swallowing Dept , Varanasi, India; 9 Kidwai Memorial Institute of Oncology, Radiation Onoclogy, Bangalore, India Purpose or Objective The standard of treatment in Post-operative head and neck ca is adjuvant RT or chemoradiation. Management of nutrition in these pts becomes prime importance due to acute reactions, weight loss leading to treatment breaks, and hospitalization. Early counseling and insertion of Nasogastric tube(NGT) in post-op chemoradiotherapy post(POCTRT) patients help in minimizing the treatment gap and weight loss during POCTRT. This study was a retrospective audit from 2019 to 2020 for all POCTRT patients and the timing of the use of NGT and its effect on weight loss and treatment breaks during POCTRT. Materials and Methods A total of 92 patients were given POCTRT between Jan 2019 and Aug 2020 who were audited for the timing of NGT insertion, weight loss, and treatment gap during the treatment. The total dose of POCTRT to a total dose of 60Gy/30#/ 5-6 weeks. Informed consent was taken from each patient and the EORTC QLQ-C30 questionnaire and QLQ-H&N35 module were used for assessing the QOL. All patients were treated with the Rapid arc technique. Global health status(GHS), Functional scale (FS), and Symptom scale(SS) values were assessed for various parameters. A general linear model multivariate analysis of variance was used to analyze the prognosticators of HR-QoL. Results The mean age at the time of diagnosis was 50±9yrs and the male to female ratio was 2:1 in the study population. The study population had a mean global health status (GHS) for overall QOL of 55.5 ± 13.4. All 92 patients completed the treatment and 1 patient died after treatment due to aspiration, was noted. The GHS, FS, and SS score at the start of treatment were 54.2±12.1, 86.0±6.2, 10.0±8.01, at the end of treatment was 50.8±9.6, 82.0±5.5, 12.4±6.6 and 4 months after treatment was 58.4±4.6, 88.9±4.8, 8.3±3.6 respectively. Gender and age did not contribute significantly. The QOL studies also showed that the symptoms gradually improved with treatment. Out of 92 Patients who were treated with chemoradiation, 59 patients need NGT insertion, and 33 patients completed chemoradiation without NGT insertion. Significant weight loss(more than 5% of baseline weight) was found in 22% of patients in whom NGT insertion was done as against 43% who refused NGT insertion. NGT insertion was most commonly done at 2-3 weeks of treatment. Conclusion Conclusion:- Early insertion of ryles tube by 2 nd week of POCTRT improves both QOL and decreases weight loss. Hence prophylactic NGT insertion may be recommended if the patients agree to NGT insertion in the early part of the treatment. Compromised HRQOL and functional deficits among patients with POCTRT before the start of treatment, was observed in this study. The adoption of a QOL assessment as a standard procedure in hospital settings can contribute to anticipating interventions aimed at reducing the impact of therapeutic applications and improve subsequent patient management. 1 Medical School, Sfax University, Radiotherapy Department Habib Bourguiba Hospital Sfax Tunisia, Sfax, Tunisia; 2 Medical School, Sfax University, Medical Oncology Department Habib Bourguiba Hospital Sfax Tunisia, Sfax, Tunisia Purpose or Objective Radiation induced hypothyroidism in nasopharyngeal cancer (NPC) ranged from 15% to 55%. In reported data, it is considered as a common late complication of definitive radiation and is mainly observed 2 years after the end of treatment. The aim of this study was to evaluate the incidence of early hypothyroidism within 6 months after radiotherapy. Materials and Methods From June 2017 to February 2020, 35 patients treated with concurrent chemo-radiotherapy (CCR) for NPC were included in this prospective study. Median age was 49 years [23-68] with a sex ratio of 2.88. All patients received intensity modulated radiotherapy (IMRT) at a dose of 69.96 Gy in 33 daily fractions with weekly cisplatin (40mg/m ² ) chemotherapy. Thyroid stimulating hormone (TSH) and Free Thyroxine 4 (FT4) dosage was performed before the start of radiotherapy and 6 months after. Different dosimetric parameters for the thyroid gland were reported: the volume (cc); the mean dose (Dmean) and the percentage of volume receiving more than 45 Gy (V45Gy). Wilcoxon Test was used to compare these different parameters between patients with or without hypothyroidism. For the remaining 30 patients, 9 patients (30%) developed a hypothyroidism 6 months after the end of radiotherapy. The median thyroid volume was 10.3 cc [4.6-23]. The median Dmean and V45Gy were 48.3 Gy [43.15-55.4] and 74.8 [38.2-97.9] respectively. No significant difference was noted for all studied parameters. Conclusion Early hypothyroidism occurring within 6 months after CCR for NPC seems to be a common complication (30%) that should be screened. Good patient monitoring with regular dosage of TSH and FT4 makes it possible to treat hypothyroidism in asymptomatic phase. This would be correlated with an improvement in the quality of life of these patients. The results of PO-0157 Early hypothyroidism after radiotherapy for nasopharyngeal carcinoma N. Fourati 1 , Z. Fessi 1 , F. Dhouib 1 , W. Siala 1 , A. Khanfir 2 , W. Mnejja 1 , J. Daoud 1 Results At baseline, 5 patients (14.3%) had hypothyroidism and were excluded from the analysis.