ESTRO 2021 Abstract Book

S800

ESTRO 2021

independent prognostic value for any of the considered outcomes. The presence of PNI resulted to be associated with a worse RFS (p=0.01) and LRFS (p=0.03). All other risk factors (close/positive surgical margins, LVI and tumor grading) were not independent prognosticators for any of the considered outcomes. PORT represents an independent prognostic factor only for DFS (p=0.03) although a trend was shown also for RFS (p=0.06). Conclusion Our results suggest that increasing DOI alone was not sufficient to impact pts' prognosis and therefore it should be not sufficient to dictate PORT indications in early-stage patients upstaged on the sole basis of DOI. Other prognosticators (particularly PNI) should be considered to select pts for adjuvant treatments. PO-0962 Evaluation of anxiety and depression in head and neck cancer patients during radiotherapy M.U. Karim 1 , B.M. Qureshi 1 , A. Hafiz 1 , N. Ali 1 , S. Abrar 1 , H. Iftikhar 1 , A.N. Abbasi 1 1 The Aga Khan University, Oncology, Karachi, Pakistan Purpose or Objective To determine the burden of anxiety and depression among patients undergoing radiation therapy for primary head and neck cancer in a tertiary care hospital Materials and Methods This was a prospective study carried out at the section of Radiation Oncology, Department of Oncology, Aga Khan University Hospital, Karachi, from 1 st March 2016 till January 2017. Thirty-seven (37) adult patients with histologically proven head and neck cancer, receiving radiation therapy with curative intent having ECOG performance status of 0-2 were enrolled in the study based upon the inclusion and exclusion criteria. Data was recorded for chemotherapy, surgery and other demographic features. Patients were evaluated at the start of treatment, during the last week of radiation and at first follow-up after completion of radiation treatment by the investigator for the frequency of anxiety and depression by voluntarily completing brief self-reporting questionnaire of Aga Khan University Anxiety and Depression scale called AKUADS. Results Out of 37 patients with head and neck cancer enrolled in the study, 56.7% (21) had cancer of the oral cavity, 21.6% (9) of laryngeal and 5.4% (2) hypo-pharyngeal carcinoma, 5.4% (2) of paranasal sinus cancer and 8.1% (3) of the salivary gland. There were 73% (27) patients who had undergone surgery and 70.3% (26) patients received chemotherapy. During radiation treatment, 57.6% of patients were found to have anxiety and depression. At the initial visit 5 (13.5%) patients, 15 (40.5%) at last week of radiotherapy and 8 (21.6%) at the first post-treatment follow up visit were found to be positive for anxiety and depression. There was a significantly increased mean depression score at the last week of radiation therapy when compared to the start of radiation (p<0.001). However, even though there was a trend observed towards poorer mean depression scores at first follow-up after radiation therapy, but it did not reach statistical significance compared to baseline depression scores (p=0.08). Conclusion The frequency of anxiety and depression among patients undergoing radiation therapy for primary head and neck cancer was found to be significantly high during the last week of radiation treatment. There was a higher incidence among patients who had surgery and chemotherapy along with radiation therapy for the head and neck. Based on these results, it is recommended that psychiatric support during radiation therapy may play an integral role in improving the quality of life of the patients during the treatment. PO-0963 How to optimize prognosis prediction of nasopharyngeal carcinoma in the era of modern radiotherapy? O. Nouri 1 , W. Mnejja 2 , N. Fourati 2 , F. Dhouib 2 , W. Siala 2 , I. Charfeddine 3 , A. Khanfir 4 , L. Farhat 2 , J. Daoud 2 1 Habib Bourguiba Hospital, Radiotherapy department, Sfax, Tunisia; 2 Habib Bourguiba Hospital, Radiotherapy, Sfax, Tunisia; 3 Habib Bourguiba Hospital, ORL, Sfax, Tunisia; 4 Habib Bourguiba Hospital, Medical Oncology, Sfax, Tunisia Purpose or Objective The 7th edition of the UICC/AJCC staging system (SS) seems to be “outdated” as it was mainly based on the studies with 2D/3D radiotherapy (RT). The 8th edition has made some amendments according to recent studies. Other studies reported nasopharyngeal tumor volume as an important prognosis factor. We aimed to evaluate and compare tumor volume with these two editions of SS for nasopharyngeal carcinoma in patients treated with intensity modulated radiotherapy (IMRT). Materials and Methods We retrospectively reviewed the data of 52 patients with NPC treated with IMRT in our institution between 2016 and 2019. All patients received 3 courses of induction chemotherapy (CT) followed by concomitant CT- RT. All patients were restaged according to the 7 th and 8 th editions SS. A dosimetric-computed tomography was made before induction CT. Tumor and lymph node volumes (GTV) were delineated. The 3-year overall survival (OS) and disease free survival (DFS) were studied with the Kaplan-Meier method and the log-rank test in univariate analysis. ROC curves were used to determine the cutoff value of the GTV and to assess prognostic values using the area under the curve (AUC). Results According to the 7 th edition, tumors were classified as stage II in 6 cases (12%), stage III in 15 cases (29%), stage IVa in 17 cases (33%) and stage IVb in 14 cases (26%). According to the 8 th edition, tumors were classified as stage II in 7 cases (14%), stage III in 22 cases (42%), stage IVa in 9 cases (18%) and stage IVb in 14 cases (26%). Median GTV was 92.7 ml [28.1-295.9 ml]. Patients were divided into two groups according to the cut-off value of GTV (<99.2 ml or >99.2 ml).