ESTRO 2020 Abstract book

S477 ESTRO 2020

complete response to CRT, suggesting that well-nourished patients experienced better outcome. Furthermore, patients with better nutritional status as indicated by a high pre-CRT serum albumin level (p=0.0188) and pre-CRT PNI >50 (p=0.0448) had significantly higher 5-year recurrence-free survival. The analysis also revealed that changes in total cholesterol (p=0.0376), adiponectin (p=0.0175) and white blood cell count (p=0.0330) were associated with patients’ recurrence-free survival. Conclusion In conclusion, our study suggested that the pre-CRT nutritional status is an important indicator of response to CRT in HNSCC patients. Assessing PNI by serum albumin concentration and peripheral blood lymphocyte count is a relatively simple way to evaluate the nutritional status of patients before curative CRT and may contribute to improved patient care. PO-0796 Observational study of radiotherapy plus cetuximab in patients with LA-SCCHN: JROSG12-2 Y. Ota 1 , T. Kodaira 2 , M. Shimokawa 3 , H. Fujii 4 , T. Nakashima 5 , N. Monden 6 , T. Yokota 7 , A. Homma 8 , S. Ueda 9 , U. Takashi 10 , J. Itami 11 , S. Noda 12 , Y. Nishimura 13 , M. Someya 14 , M. Kobayashi 15 , A. Terahara 16 , A. Yorozu 17 , H. Onishi 18 , T. Akimoto 19 1 Hyogo Cancer Center, Radiation Oncology, Hyogo, Japan ; 2 Aichi Cancer Center Hospital, Therapeutic Radiation Oncology, Aichi, Japan ; 3 Yamaguchi University Graduate School of Medicine, Biostatistics, Yamaguchi, Japan ; 4 Jichi Medical University, Clinical Oncology, Tochigi, Japan ; 5 National Hospital Organization Kyushu Medical Center, Otorhinolaryngology, Fukuoka, Japan ; 6 National Hospital Organization Shikoku Cancer Center, Head and Neck Surgery, Ehime, Japan ; 7 Shizuoka Cancer Center, Gastrointestinal Oncology, Shizuoka, Japan ; 8 Hokkaido University Graduate School of Medicine, Otolaryngology- Head and Neck Surgery, Sapporo, Japan ; 9 Kindai University Nara Hospital, Medical Oncology, Nara, Japan ; 10 Chiba University Graduate School of Medicine, Diagnostic Radiology and Radiation Oncology, Chiba, Japan ; 11 National Cancer Center Hospital, Radiation Oncology, Tokyo, Japan ; 12 Saitama Medical University International Medical Center, Radiation Oncology, Saitama, Japan ; 13 Kindai University Faculty of Medicine, Radiation Oncology, Osaka, Japan ; 14 Sapporo Medical University School of Medicine, Radiology, Sapporo, Japan ; 15 Jikei University School of Medicine, Radiology, Tokyo, Japan ; 16 Toho University Omori Medical Center, Radiology, Tokyo, Japan ; 17 National Hospital Organization Tokyo Medical Center, Radiation Oncology, Tokyo, Japan ; 18 University of Yamanashi, Radiology, Yamanashi, Japan ; 19 National Cancer Center Hospital East, Radiation Oncology and Particle Therapy, Chiba, Japan Purpose or Objective Radiotherapy plus cetuximab (bioradiotherapy: BRT) is one of the standard care methods for locally advanced squamous cell carcinoma of the head and neck (LA- SCCHN). Since its adequate indication in clinical practice is not well known regarding its efficacy and toxicity in real- world (i.e., non-trial) settings. Thus, we aimed to clarify the clinical outcomes of BRT for patients with LA-SCCHN. Material and Methods This prospective observational study included 171 patients with LA-SCCHN from 38 centers in Japan who started BRT from August 2013 to December 2016 with minimum 1 year follow up. Patients with cancer of the oropharynx (n=70), hypopharynx (65), larynx (31), and oral cavity (5) were enrolled. 152 patients were male, and the performance status were 0-1 in 165 patients and 2 in 6. Median age was 67 (36–85), and 34 patients (20%) were 75 years old or older. 114 patients (66.7%) had stage IVA disease. This study received support from Merck Biopharma, and was

with a simultaneous integrated boost IMRT/VMAT technique according to the following doses: 67.5 Gy or 70.5 Gy in 30 fractions to primary tumor and involved nodes, 60 Gy to high-risk nodal areas, and 55.5 Gy to low- risk nodal areas. Concomitant weekly cisplatin was associated. Toxicity was evaluated according to WHO and RTOG scales. Results Fifty-seven patients (median age: 58 years, range 32-76; male/female ratio: 52/5) were retrospectively analyzed. The most represented primary sites were oropharynx (35%), larynx/hypopharynx (23%), nasopharynx (19%) and oral cavity (17.5%). The majority of pts had clinical IV stage (46 pts, 81%), nodal involvement was present in 38 cases (67%). Before Radio-Chemotherapy (RCT), 32 (56%) pts received CF and 25 (44%) pts received DCF. Asthenia was the most frequent symptom reported by pts. Four (7%) pts showed a Grade ≥3 hematologic toxicity. Concerning RCT, 70.5 Gy and 67.5 Gy were delivered in 28 (49%) and 27 (47%) pts, respectively. VMAT strategy was preferred in 58% of cases, while IMRT in the remaining 42%. Fifty-five pts (96%) completed the overall treatment as prescribed. Twenty-six (46%) required at least one day CRT rest (mean: 2.7 days, range 0-24). Two pts (3%) failed to complete CRT due to severe toxicities (mucositis and arrhythmia), while 13 patients (23%) reported Grade 3 mucositis and 1 pt (2%) Grade 3 dysphagia. Within one-month after the end of treatment, 3 pts (5%) died because of heart failure. Twenty-eight (49%) pts had clinical response after iCT, with an overall response rate of 79% after RCT (complete response rate: 52%). Two-year local control was 72.4%, the 2-year progression free survival and overall survival were 68% and 73%, respectively. Conclusion A moderately accelerated IMRT/VMAT CRT was feasible after iCT. An overall early death rate of 5% highlights the need for suitable predictive criteria to better select those patients who are most likely to benefit from this treatment modality and less likely to experience severe toxicity. PO-0795 Pre-chemoradiotherapy nutritional status affects treatment response and survival in HNSCC patients Y.M. Liou 1 , C. Kuo 1,2 , Y. Lee 1 , Y. Huang 3,4 , C. Pan 4,5 , J.L. Chen 4,6 1 National Taiwan University Hospital, Laboratory Medicine, Taipei, Taiwan ; 2 National Taiwan University College of Medicine, Clinical Laboratory Sciences and Medical Biotechnology, Taipei, Taiwan ; 3 National Taiwan University Hospital, Medical Imaging, Taipei, Taiwan ; 4 National Taiwan University College of Medicine, Radiology, Taipei, Taiwan ; 5 National Taiwan University Hospital, Medical Research, Taipei, Taiwan ; 6 National Taiwan University Hospital, Oncology, Taipei, Taiwan Purpose or Objective Concurrent chemoradiotherapy (CRT) is increasingly being used in the treatment of non-metastatic head and neck squamous cell carcinoma (HNSCC). The response to CRT is variable and may depend on the nutritional status of the patients. We hypothesized that HNSCC patients with better nutritional status before CRT will experience lower tumor progression risks and better prognosis. Material and Methods A total of 28 patients were prospectively enrolled. Serum biochemical nutritional profile including levels of albumin, total cholesterol, adiponectin, and leptin; complete blood count; and body mass index (BMI) were measured before and 2 weeks after CRT. The prognostic nutritional index (PNI) was calculated based on the serum albumin concentration and peripheral blood lymphocyte count. Results The median follow-up was 47.1 months. Pre-CRT serum albumin level (p=0.0151), BMI (p=0.0037), and PNI (p=0.0218) were significantly higher in patients achieving