ESTRO 38 Abstract book

S647 ESTRO 38

and treatment characteristics were considered. The whole oral mucosa was divided in 4 subsites: palate, base of tongue (BOT), oral cavity (OC) and posterior wall of pharynx (PWP). Planning target volumes were subtracted from the whole oral mucosa and from each subsite and dose–volume histogram (DVH) data were extracted.

EP-1169 Evaluation of swallowing function with PSSHN scale for head and neck cancer patients undergoing IMRT S. Agarwal 1 , P. Mukherjee 1 , M. Roy 1 , S. Kommineni 1 , N. Kalyani 1 1 Jaslok Hospital and Research Centre, Radiation Oncology, Mumbai, India Purpose or Objective Head neck radiotherapy is associated with significant swallowing and speech dysfunction. Intensity modulated radiotherapy may allow us to reduce the doses to swallowing structures and decrease associated morbidity. Aim of present study is to prospectively access change in swallowing function using PSSHN questionnaire. Material and Methods This is a prospective; ethics approved protocol for assessment of change in swallowing functions for head neck carcinoma patients undergoing curative intent radiotherapy with or without concurrent chemotherapy. Patients were asked to fill up PSSHN questionnaire at baseline, at conclusion of radiation and at 3 months post radiation. Change in PSSHN scores were evaluated for all patients. CTRI Registration No is CTRI/2017/11/010378. Results Between August 2017 to April 2018, 61 patients were enrolled in the study and written informed consent was obtained. Primary sites were: Buccal mucosa 21, Oral Tongue 12, Oropharynx 10, Hypopharynx 5, Larynx 5 and Naopharynx 4. All patients were treated with IMRT with median RT dose of 60 Gy. Thirty seven patients received concurrent chemotherapy. Three patients were excluded from analysis (One died, two withdrew consent). The mean weight loss was 5 kg (range: 3-12 kg). Seventeen patients needed nasogastric tube / PEG tube during radiation. At 3 month follow up, 1 patients had persistant nasogastric tube. Mean PSSHN score at baseline was 228. The mean score at completion of RT was 142 with mean decline in score was 86 (Range 10-225). The mean score at 3 months post RT was 225. Normacy of diet was worst affected domain in PSSHN at completion of RT. There was no significant correlation between ipsilateral or bilateral nodal irradiation and decline in PSSHN scores. Buccal mucosa primary site had less decline in scores as compared to other sites however difference was not significant. Conclusion There is significant decline in PSSHN score at completion of radiation with normalcy of diet being worst affected domain. There was almost recovery of PSSHN scores after 3 months post completion of radiation. EP-1170 Predictive factors of chemoradiation induced oral mucositis in head and neck cancer patients. F. Arcadipane 1 , E. Olimpo 2 , R. Ragona 2 , G.C. Iorio 2 , S. Martini 2 , E. Gallio 1 , P. Franco 2 , U. Ricardi 2 1 Città della Salute e della Scienza, Department of Oncolgoy- Radiation Oncology, Torino, Italy ; 2 University of Turin, Department of Oncology- Radiation Oncology, Torino, Italy Purpose or Objective Radiation-induced oral mucositis (OM) is a major dose- limiting toxicity in head and neck cancer (HNC) patients. It is a normal tissue injury caused by chemotherapy (CT) and/or radiotherapy (RT), which has marked adverse effects on patient quality of life and cancer therapy continuity. We prospectively evaluated a cohort of patient affected with HNC and treated with CT/RT in order to identify dosimetric parameters and clinical characteristics predictive for OM occurence Material and Methods We proposed a series of questionnaires, concerning pain (VAS score), quality of life and functional endpoints (OMWQ-HN, FACT-HN) to a total of 41 HNC patients. To define OM, both WHO and OMAS scores were used. Patient

DOSIMETRIC PARAMETERS

ORAL MUCOSA 43,90 [12,57] 65,90 [10,87] 87,56 [20,67] 75,30 [23,78] 50,69 [25,75] 42,97 [25,50]

PALATE BOT

OC

PWP

37,72 [15,62] 53,87 [15,28] 42,50 [13,69] 56,43 [16,40] 61,54 [12,86] 61,45 [13,36] 78,65 [30,95] 94,23 [20,15] 87,70 [21,64] 64,70 [33,03] 89,96 [24,27] 72,77 [26,44] 37,04 [30,09] 75,74 [35,47] 45,96 [30,03] 28,63 [27,92] 69.71 [37,38] 38,53 [29,79]

53,28 [14,86] 60,63 [12,25] 90,73 [19,43] 86,00 [24,22] 77,14 [33,16] 72,37 [35,22]

Average dose

D 1cc

V20

V30

V45

V50

Table 1 Dosimetric Parameters; [Standard Deviation] Results A similar trend during treatment and follow-up was found both for the OMAS and PRO scores. In our analysis patient's age (p=0,02), V30 (p=0,02) and V45 (p=0,03) of the oral mucosa, resulted to be significantly related to OM. The maximum dose (Dmax) received from PWP was relatedto Mean Mucositis Score (MMS) (p=0.023), Weighted Mean Mucositis Score (WMMS) (p=0.022) and Extent of Mucositis Score (EMS) (p=0.05). Palate Dmax was related to MMS (p=0.05), WMMS (p=0.05). For BOT, the average dose was cooorelated to Worst Site Score (WSS) (p=0.05). (Fig.1) OM was found to be significantly related to induction CT (WMMS p=0.06 and WSS p=0.08) and concomitant CT (MMS p=0.07). Among patients with G3 OM, 93,3% were given concomitant CT while 6,7% underwent exclusive RT (p=0.07). (Fig.2)