ESTRO 38 Abstract book

S642 ESTRO 38

and Treatment for Cancer (EORTC) QLQ-C30 and EORTC HN35. Conclusion Intensive NI following the ADA MNT protocol results in improved dietary intake compared with SP and appears to beneficially impact on nutrition related outcome in patients receiving radiotherapy. All patients undergoing radiotherapy either alone or with concurrent chemotherapy should receive thorough nutrition assessment, adequate nutritional counselling and nutritional support for a meaningful clinical outcome. EP-1160 Quantifying the impact of radiologic revision in head and neck cancer: monoinstitutional experience D. Alterio 1 , L. Preda 2 , S. Volpe 1,3 , C. Giannitto 2 , G. Riva 1,3 , A.F. Pounou Kamga 1,3 , M. Atac 4 , G. Giugliano 4 , A. Ferrari 1 , G. Marvaso 1 , S. Durante 1,3 , S. Arculeo 1,3 , I. Turturici 5 , M. Cossu Rocca 6 , M. Ansarin 4 , M. Bellomi 2 , B.A. Jereczek-Fossa 1,3 , R. Orecchia 7 1 European Institute of Oncology IRCCS, Department of Radiation Oncology, Milan, Italy ; 2 European Institute of Oncology IRCCS, Department of Radiology, Milan, Italy ; 3 University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy ; 4 European Institute of Oncology IRCCS, Department of Head and Neck Surgery, Milan, Italy ; 5 University of Rome- Tor Vergata, Department of Radiation Oncology, Rome, Italy ; 6 European Institute of Oncology IRCCS, Department of Head and Neck and Urogenital Medical Oncology, Milan, Italy ; 7 European Institute of Oncology IRCCS, Scientific Directorate, Milan, Italy Purpose or Objective Although the role of the radiologist as a core member of the multidisciplinary team (MDT) for Head and Neck (HN) cancer management has been increasingly advocated, a quantitative analysis on the impact of imaging revision is not available in currently published works. To address this unmet need, the current study provides a full report of MDT meetings held at a tertiary care cancer center at the presence of expert dedicated HN radiologists. Material and Methods Retrospective revision of cases discussed at MDT meetings from April 2014 to March 2017 for whom a radiologic revision was required. All cases were revised by two dedicated HN radiologists (LP and GC having 15 and 5 years experience in HN cancer imaging, respectively). Inclusion criteria were: 1) clinical and/or radiological suspicion or histologically-proven diagnosis of HN cancer, 2) availability of a written medical record of the MDT discussion and final radiological report 3) follow-up length of at least 12 months, 4) written informed consent for the use of personal data for educational and scientific purposes. Exclusion criteria were: adjuvant treatment (i.e. radiation treatment alone or in association with systemic therapies) and/or diagnosis of thyroid cancers. Both malignant and benign tumors were included. Only computed tomography (CT) and magnetic resonance (MR) imaging were considered. The following descriptors were used: 1) any changes of radiological staging (per Tumor Node Metastasis, TNM, staging system 7th ed.) 2) any changes in treatment strategy. The latter were categorized as either “major modifications” (i.e. MDT non indication to surgery in favor of radiotherapy± systemic therapy) or “minor modifications” (i.e. MDT indication to an alternative approach: open versus minimally-invasive surgery). Accuracy of MDT indication-to-treatment was verified through follow-up data (pathological specimens and/or subsequent imaging and/or clinical information). Results Five-hundred forty cases were retrieved, mainly at the time of tumor diagnosis (57%) and locally-advanced tumors (69%). The most represented HN subsite was the oropharynx (28%). MR-only was the most commonly reviewed type of imaging (46%), followed by CT-only

patients received a COMP-RT. The long-term quality of life (QOL) of the patient was evaluated using the Quality of Life Questionnaire for Head and Neck 35. Results After a median follow up of 6.3 years, primary tumour emerged in 3 (13%) patients in UL-RT group and in 4 (9%) patients in COMP RT group (p=0.68). There were no differences (p=0.34) in cervical node recurrence rate between UL-RT group (4%) and COMP-RT group (22%). The locoregional recurrence free survival rate at 5-years was 81% in UL-RT group and 68.6% in COMP-RT group (p=0.21). When comparing it with COMP-RT, UL-RT had a trend to an improvement of the QOL related to teeth problems, swallowing, troubles with social contact and use of pain killers. Conclusion Unilateral postoperative radiotherapy provides similar outcomes as COMP-RT in unilateral HNCUP management. This radiotherapy modality seems to improve radiation morbidity and long term QOL of patients without compromising re-irradiation possibilities. EP-1159 To compare outcome of Intensive nutritional support with standard practise in head ands neck cancer. T. Shahid 1 , N. Kalyani 1 , S. Modak Das 2 , M. Mukherjee 1 , J. Bhattacharya 1 , A. De 1 , R. Talukdar 1 , A. Samanta 1 , T. Ghosh 1 , D. Barman 1 , S. Sadhukhan 1 , P. Vijayaraghavan 1 , R. Rajan 1 1 Apollo Gleneagles Hospital, Radiotherapy, Kolkata, India ; 2 Apollo Gleneagles Hospital, Nutrition and Dietics, Kolkata, India Purpose or Objective A randomized control study to evaluate the effect of Nutritional support following the American Dietetic Association Medical Nutrition Therapy (ADA MNT) protocol with standard practise (SP) for patients of head and neck cancer undergoing radiotherapy either alone or with chemotherapy.To determine the impact of nutritional intervention (NI) compared with standard practice (SP). Malnutrition related to persistent poor oral intake during radiation has significant adverse impact on clinical outcome and quality of life. Nothing much can be done in majority of our patients due to resource and financial crunch in our country. Henceforth, after radiotherapy, the nutritional status of the patients is poor and the curative effect is often unsatisfactory. Material and Methods 60 patients, previously untreated and biopsy proven squamous cell carcinoma histology to be treated with either radical radiotherapy or radical concurrent chemo radiation with curative intent were included. (50 Male and 10 Female). Mean age being 51 years.Patients were randomized to receive either NI (n=31) (nutrition counseling following the American Dietetic Association Medical Nutrition Therapy (ADA MNT) protocol for radiation oncology) or SP (general nutrition talk and booklet)(n=29). Main outcome measure was dietary intake (protein and kilocalorie) assessed at baseline, 4, 8 and 12 weeks after starting radiotherapy. Statistical analyses repeated measures ANOVA performed on an intention to treat basis. Results The NI group had a higher mean total kilocalorie (p=0.02) and protein intake (p<0.001) compared with the SP group. Mean intake per kilogram of body weight for the NI group ranged from 29 to 32 kcal/kg/day compared with 24 to 28 kcal/kg/day for the SP group (p=0.02). The NI group had a higher mean protein intake (1.2-1.4g/kg/day) compared with the SP group (1.0-1.1g/kg/day) (p=0.001). Treatment breaks were seen in 10 % of patients in NI group as compared to 30 % in SP group. Even the Health related Quality of Life (HRQOL) was better in the NI group. HRQOL was measured by the European Organization for Research