ICHNO-ECHNO 2022 - Abstract Book

S53

ICHNO-ECHNO 2022

Radiation Onoclogy, Bangalore, India; 4 kidwai Memorial Institute Of Onoclogy, Radiation Onoclogy, Department Of Epidemiology And Statistics, Bangalore, India; 5 department Of Epidemiology And Statistics, Radiation Onoclogy, Kidwai Memorial Institute Of Onoclogy, India; 6 mpmmcc And Hbch, Radiation Onoclogy, Varanasi, India Purpose or Objective Oral mucositis is the debilitating complication in patients undergoing radical radiotherapy with or without chemotherapy for squamous cell carcinoma of the head and neck. It is one of the major acute morbidities causing pain and dysphagia leading to treatment breaks and hospitalization which has a major impact on prognosis and treatment outcome. Despite the significant detrimental sequelae associated, there is no consensus on the optimum oral care regimen to prevent severe oral mucositis. This study was conducted to evaluate the effect of bio adhesive lipid barrier on oral mucosa, which acts as a mechanical barrier for the treatment of oral mucositis in patients with head-and-neck cancer undergoing radical radiotherapy with or without chemotherapy in a clinical setting. Materials and Methods Twenty-five patients with Head and Neck cancer proven histopathologically, after obtaining informed written consent were enrolled for the study. At screening, patients were required to have symptomatic oral mucositis (RTOG Grade 2 or above) and oral pain scores of at least 6 on an 11-point Likert scale at screening and on each day before radiotherapy. Patients were administered bioadhesive oral spray three times in a day and oral mucositis pain, dysphagia and odynophagia were assessed in terms of severity and duration at 5 minutes,30 minutes,1,2,4 and 6 hours. Results During the screening, 64% of patients had Grade III and 36% had Grade II Oral mucositis. After treatment, Patients experienced a median 57.1% decrease in pain intensity immediately within 5 minutes lasting up to 30 minutes and 42.9% up to 2 hours.The median pain intensity score reached 3 point on Likert scale at 5 minutes following oral spray application and was maintained up to 1 hour (i.e., patients experienced an average 3-point decline in pain intensity from baseline to 1 hour after treatment). Regarding rescue medication, only paracetamol was used in a total of 2 patients (8 %) during the treatment period. Opioids were not used as a rescue medication in any of the patients. Only 3 patients (12%) had the necessity for the Nasogastric tube. Dysphagia improved in 22 patients (88%) from semisolids to solids consumption within 5 minutes and lasted up to 6 hours in 7 patients (28%) with p<0.05 at end of 6 hours. Whereas, odynophagia reduced within 5 minutes in 22 patients (88%) and lasted up to 4 hours in 6 patients (24) with p<0.05 at end of 4 hours. The mean difference in weight loss during the treatment ranged from 0.7kg to1.6kg. Conclusion The bioadhesive barrier-forming oral liquid is efficacious in reducing pain in patients with oral mucositis undergoing radical radiotherapy with or without chemotherapy for head-and-neck cancer and demonstrated its potential value in clinical application. The analgesic effect was immediate, clinically significant, and persisted for up to 6 hours. It is well tolerated and the trend towards less Nasogastric tube-dependency and a possible reduction in In-patient time is promising. 1 AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Cracow, Poland; 2 University Children's Hospital of Cracow, Department of Medical Physics, Cracow, Poland; 3 University Children's Hospital of Cracow, Department of Medical Physics , Cracow, Poland; 4 AGH University of Science and Technology, Faculty of Physics and Applied Computer Science , Cracow, Poland Purpose or Objective The objective of radiotherapy treatment planning is to deliver a prescribed dose to the target volume while minimizing the dose delivered to surrounding healthy tissues. The high-energy photon beam exhibits a skin-sparing (build-up) effect that is considered beneficial for deep-seated tumours. Unfortunately, this effect becomes problematic for the superficial tumours and can result in underdosing, resulting in ineffective treatment. An additional tissue-like material, the bolus, is used to ensure adequate therapy. Commonly-used gel boluses do not always conform perfectly to the complex, irregular shape of a patient's surface. As a result, it can cause unwanted air gaps and significantly affect irradiation efficiency. Minimizing air gaps seems to be the biggest challenge when dealing with complex geometries for head and neck (HN) cancer patients. In this study, a customized bolus printed in a 3D printer was compared to a commonly used gel bolus in terms of volumes of air gaps, conformity and uniformity of the target area coverage and workflow. Materials and Methods For 4 different infill percentages of 3D printed bolus, computer tomography was acquired and Percentage Depth Dose (PDD) in the water phantom was measured, using Ross chamber and a 3D printed tripod specially designed for these purpose (Fig. PO-0092 The usefulness of 3D printed bolus for head and neck cancer radiotherapy A. Czubowicz 1 , M. Mucha 2 , M. Owcarz 3 , A. Chmiel 3 , K. Matusiak 4 , J. Tarasiuk 4