ICHNO-ECHNO 2022 - Abstract Book

S113

ICHNO-ECHNO 2022

Conclusion Cetuximab monotherapy as intended last-line treatment outside clinical trials show efficacy that are in line with data obtained from clinical studies using cetuximab as first-line systemic treatment.

PO-0179 Once-weekly hypofractionated palliative RT in poor PS and elderly patients with H&N cancer

D. Delishaj 1 , A. Cocchi 1 , F. Colangelo 2 , A. Alghisi 1 , G. Mandurino 2 , R. D'Amico 1 , G. De Nobili 1 , F. Bonsignore 3 , F. Declich 3 , S. Giulia 3 , I. Buti 3 , C. Frigerio 3 , C.P. Soatti 1 1 Alessandro Manzoni Hospital, Radiation Oncology, Lecco, Italy; 2 University of Milano Bicocca, Radiation Oncology, Milan, Italy; 3 Alessandro Manzoni Hospital, Medical Physics , Lecco, Italy Purpose or Objective The aim of this study was to evaluate survival rates as well as acute and late toxicity after hypofractionated palliative radiotherapy (RT) in patients (pts) with head and neck (H&N) cancer unfit of standard RT treatment. Materials and Methods Between December 2010 and June 2020, 65 patients with advanced H&N cancer underwent hypofractionated palliative RT treatment. The prescribed dose was 36,75-42 Gy in7-8 fractions given 1 fraction of 5,25 Gy weekly. All pts underwent CT simulation on supine position using 2.5-3 mm slice thicknesses. As immobilization system we utilized a head thermoplastic mask. CTV often coincided with GTV and PTV was obtained by GTV-CTV + a margin of 3-5 mm. The treatment was performed with Versa HD™ or Synergy linear accelerator of Elekta company (Stockholm- Sweden). A VMAT or IMRT technique was used in 23 pts (35,4 %) and a 3DCRT technique in 42 pts (64,5%). Concomitant systemic chemotherapy (CT or immunotherapy) was administered in only 4 patients (6 %). At the moment of RT start the median KPS was 60 (range 40-90). Results At analysis 36 patients (55,4%) were male and 29 (45,6%) were female. Mean age was 79 years old (range 42-100 years old). After a mean follow-up of 9 months the mean overall survival was 10 months (median of 6 months) with a median PFS and LC of 4 months. Overall, 60 % of patients completed RT at the prescribed dose and 40 % interrupt it due to PD, clinical worsening or lost motivation. A clinical or radiological examination response was observed in 54 % of patients; CR 23 %, PR 31 %, SD 6 % , PD 19 % in reaming 21 % was not possible to evaluate the response.. In patients receiving the prescribed dose the response rate was 79 %, of them 34,2 % had a CR. Patients that completed RT treatment at the prescribed had a higher survival rate compared to patients which interrupt RT treatment (8 mths vs 2 mths; p-value 0,0001). In patients receiving 42 Gy in 8 fractions the median OS was 11 months. Moreover, KPS > 70, PTV < 400 cc, and clinical or radiological response were prognostic factors regarding OS (p- value < 0,05). A G2 acute or late toxicity was observed in 29 % of patients (36 % in pts treated with IMRT-VMAT; 38 % in pts receiving 3DCRT). A G3 or higher acute or late toxicity was observed in 4,5 % of pts (G3 1,5 %; G4 1,5 % and 1,5% G5); all cases with ≥ G3 toxicity were treated with 3DCRT technique . Conclusion Weekly palliative hypofractionated radiotherapy treatment appears acceptable in H&N cancer unfit of other treatment strategy. Radiotherapy total doses delivered, KPS > 70, PTV < 400 cc resulted prognostic factors regarding OS. Particular attention must be paid regarding late toxicity in this subset of pts. IMRT-VMAT technique is recommended to be used for this schedule of hypofractionated palliative treatment due to reduce G2 or higher toxicity. 1 University Medical Centre Groningen, Radiation Oncology, Groningen, The Netherlands; 2 Netherlands Cancer Institute, Head and Neck Surgery and Oncology, Amsterdam, The Netherlands; 3 University Medical Centre Groningen, University Centre for Geriatric Medicine, Groningen, The Netherlands; 4 University Medical Centre Groningen, Otorhinolaryngology/Head & Neck Surgery, Groningen, The Netherlands Purpose or Objective Head and neck cancer (HNC) patients are often frail; therefore, frailty screening is desirable. In many hospitals in the Netherlands, frailty screening is currently routinely applied. However, there is no consensus on best implementing this in clinical practice. This study aimed to identify the interhospital variation of frailty screening in the work-up of HNC patients in the Netherlands. Materials and Methods An online survey was sent to all eight head and neck oncology centres (HNOC) and six preferred partners hospitals (PP) in the Netherlands. The survey consisted of three parts with mostly closed-ended questions and a few open-ended questions. The first part contained questions about the number of newly diagnosed HNC patients and which patients underwent screening. The second part focused on the screening logistics (when, where, and how the screening took place) and how the frail patient was identified. The last part of the survey consisted of questions about the involvement of the geriatrician. The survey was built and sent with REDCap, an Electronic Data Capture tool provided by the University of Groningen. Results When submitting this abstract, 6 (43%) of the 14 hospitals (5 HNOC and 1 PP) filled in the survey, inclusion is still open. There is a considerable variation in the number of newly HNC patients. In all hospitals, all patients of 70 years of age and PO-0180 Practice variation in frailty screening of head and neck cancer patients: a Dutch multicentre study L. Sommers 1 , L. van der Velden 2 , R. Steenbakkers 1 , J. Langendijk 1 , S. Festen 3 , G. Halmos 4