ICHNO-ECHNO 2022 - Abstract Book

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ICHNO-ECHNO 2022

older were screened. In two centres, all patients were screened regardless of age; in the four remaining centres, patients below 70 years of age, when indicated by the physician. In all facilities, frailty screening took place by dedicated nurses before the multi-disciplinary team (MDT) meeting. There was no consensus regarding the tests used for frailty screening; half of the hospitals used multiple tests to assess frailty, while the other half used only the Geriatric-8 frailty screener. The geriatrician was consulted based on the outcome of the frailty screening. Most (5/6) of the hospitals identified and referred frail patients for a comprehensive geriatric assessment (CGA) based on a combination of the screening outcome, the medical history, and clinical judgement. In four hospitals, a geriatrician attended the oncological MDT, and in one hospital, there was a separate (frailty) MDT. In all hospitals, the CGA aims to optimise patients before treatment or to modify treatment, and the geriatrician remains involved during and after treatment. Conclusion Among the responders, some form of frailty screening is performed in all hospitals. However, there is no consensus regarding the logistics and tests used for frailty screening and assessment. Sharing the experiences on the care of frail patients may help to further optimise the care of frail HNC patients.

PO-0181 Head and neck radiotherapy for frail patients, a retrospective analysis of 27 patients.

S. Beauvois 1 , T. Dragan 1 , G. Janoray 1 , C. Al Wardi 1 , D. Van Gestel 1

1 Institut Jules Bordet, Radiotherapy, Brussels, Belgium

Purpose or Objective To verify if a radiotherapy of 50 Gy in 20 fractions is appropriate for frail head and neck cancer (HNC) patients. Materials and Methods From 10 2012 to 7 2016, 27 non-operated frail HNC patients (pts) were selected for 50 Gy radiotherapy (2.5 Gy/fr, no split). Pts had biopsy-proven epidermoid carcinoma of the buccal cavity (4), oropharynx (10), hypopharynx (8) or larynx (5). Two pts had early stage (T1-2N0) and 25 advanced disease (T3-4N1-3). Outcome was calculated from the end of radiotherapy. Results WHO performance status (PS) was 0-1 in 6 pts, 2 in 7, 3 in 13 and 4 in 1 pt. Mean and median age was 69y (37-93). Before the start of RT, 10 pts had severe weight loss and 8 had a second localization (distant metastasis (5) or second primary (3)). Beside those classical criteria, impaired mobility, insufficient motivation and cognitive troubles were present in respectively 16, 13 and 5pts. 19 pts endured the entire course of 20 fractions, others only received 19, 18, 16, 1 or 0 (4pts) sessions. Median Treatment duration was 29 days (0-38). Nine pts were lost to follow up before (4), during (3, none due to toxicity) or immediately after (2) treatment, hence could not be evaluated. Early grade 3 toxicity consisted of oropharyngeal mucositis in 60% (12/20) of pts and of dermatitis in 10% (2/21). The overall response rate of the 18 evaluable pts was 89%: 16 pts achieved a complete (10) or partial response (6) while 2 had a stable disease. All local (2), regional (1) and combined (6) recurrences occurred during the first year of follow-up. After a median follow-up of 19 months, the 1 and 2 year locoregional control (LRC) was 33% and 28%. From the 7 pts with a total (T+N) tumor volume <27 ml, 6 were controlled until death (4) or last follow up (2), and only 1 had a local relapse (T3N0 vocal cord). LRC calculated by Kaplan Meyer was significantly better for smaller tumor load (p=0.025; Fig 1). At one year 66% were alive, 33% at 2 years. Three pts survived more than 3 years, 2 without disease. Survival is correlated with stage (25ml;p=0.003), nodal volume (6ml;p=0.001) and total (T+N) tumor volume (100ml;p=0.0009); but not with WHO PS(0-1vs2-3;p=0.66/1-2vs3;p=0.37), age (69 years;p=0,14;Fig2),total treatment time (32days;p=0.69) nor number of fractions (1;p=0.19). The date of death being known for 6 of the 7 ‘lost’ patients, the 1 year survival of the remaining 26 patients was 50 %.

Figure 1: LRC according to total tumor volume (T+N)

Figure 2: Overall Survival according to age