ESTRO 38 Abstract book

S652 ESTRO 38

EP-1178 Prognostic role of FDG-PET/CT during radiotherapy in patients with hypopharyngeal carcinoma T. Mase 1 , Y. Toyomasu 1 , Y. Watanabe 1 , T. Kawamura 1 , A. Takada 1 , S. Ochiai 2 , Y. Yamashita 3 , N. Ii 4 , H. Sakuma 1 , Y. Nomoto 1 1 Mie University Hospital, Department of Radiology, Tsu, Japan ; 2 Saiseikai Matsusaka General Hospital, Department of Radiation Oncology, Matsusaka, Japan ; 3 Matsusaka Central Hospital, Department of Radiation Oncology, Matsusaka, Japan ; 4 Ise Red Cross Hospital, Department of Radiation Oncology, Ise, Japan Purpose or Objective Our study aimed to investigate the prognostic effects of 18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) during definitive radiotherapy (RT) in patients with hypopharyngeal squamous cell carcinoma. Material and Methods The pretreatment and interim PET/CT images of 38 patients with hypopharyngeal squamous cell carcinoma, receiving definitive RT between Feburary 2014 and June 2018, were evaluated prospectively. RT was delivered 5 days a week using a single daily fraction of 1.8 Gy, to a total dose of 70.2 Gy. The interim PET/CT images were taken at a cumulative RT dose ranging from 36.0 to 45.0 Gy. The maximum standardized uptake value (SUVm) of primary tumor both pretreatment PET/CT and interium PET/CT and the reduction ratio of the SUVm (SRR) between the two images were measured. Progresson-free survival (PFS) was calculated using the Kaplan-Meier method. Univariate and multivariate analyses were performed to evaluate the prognostic value of pretreatment SUVm, interium SUVm, SRR, age, sex, primary tumor site, T classification, and stage for prediction of PFS. Results The median follow-up time was 18 months (range, 6-55 months). The 1-year and 2-year PFS rates were 75.6% and 68.6 %, respectively. Eleven (29%) of 38 patients experienced disease recurrence (n=10, 26%) or death (n=4, 11%). In univariate analysis, a higher interim SUVm and a lower SRR were associated with the inferior PFS (Figure 1, Figure 2). Conducting a multivariate analysis revealed that an interim SUVm of primary tumor was an independent prognostic factor for PFS (Hazard ratio (95% CI), 12.5(1.59- 98.21); p=0.016).

EP-1177 Comparative study assessing QoL in HNSCC patients treated with Radical Radiation with IMRT vs 3DCRT M. Mukherjee 1 , J. Bhattacharya 1 , T. Shahid 1 , A. Samanta 1 , L.N. Biswas 1 , A. Jawade 1 , A. De 1 , D. Barman 1 , T. Ghosh 1 , S. Sadhukhan 1 , P. Vijayaraghavan 1 , R. Talukdar 1 , C. Saikia 1 , R. Rajan 1 , R. Raj 1 1 Apollo Gleneagles Hospital, RADIATION ONCOLOGY, Kolkata, India Purpose or Objective The purpose of the study is to assess and compare health- related quality of life (HRQOL) in patients with HNSCC, treated with radical radiotherapy with IMRT versus 3D- CRT. Material and Methods From January 2018 to May 2018, 40 patients of squamous cell carcinoma of oropharynx, larynx and hypopharynx (cT1-3 N0-2b except cT1N0 glottic cancer) undergoing radical radiotherapy either alone or with concurrent chemotherapy were included in this study. Patients were treated with radical doses with conventional fractionation using either IMRT or 3DCRT. EORTC QLQ-C30 and HN35 were used to study the HRQOL and assessed for each patients at baseline i.e. before the commencement of radiation, at 3 rd week of RT, after completion of treatment, at 1 month and at 3 months of follow up Radiation induced acute toxicities were assessed by RTOG acute toxicity criteria, every week during radiotherapy. For comparison, QOL data collected at different point of time were analyzed using unpaired ‘t’ test and for acute radiation induced toxicities chi-square test was used. Results 40 patients were evaluated in the study. The mean age of the sample population was 60 years with predominant male population (90%). Larynx was the commonest site (18 patients, 45%). 13 patients (32.5%) had T3 disease and 10 (25%) patients had node positive disease. 14 (35%) patients received cisplatin based concurrent chemotherapy. The number of patients treated with 3DCRT and IMRT were 19 and 21 respectively. HRQOL scores of various components deteriorated during and after treatment in both the arms. HRQOL scores of fatigue (24 vs 17, p=0.041), appetite loss (73 vs 44, p<0.001) and sense problems (31 vs 15, p<0.001) were significantly worse in IMRT group during and after completion of treatment. However, this differences were not evident at 3 months of follow up. Dryness of mouth and sticky saliva were significantly more in 3D-CRT group (HR-QoL score for dryness of mouth 60 vs 0, p<0.001 and for sticky saliva 9.52 vs 0, p=0.24) during radiation and 3 months after completion of treatment.Insomnia and ill feeling were found to be significantly more in 3DCRT arm. Other parameters like global health, physical, emotional and social functions, speech and swallowing, nutritional parameters remained comparable in both arms. There was no grade 4 or above acute toxicities. No significant difference was observed in acute toxicities e.g. mucositis, dysphagia, skin toxicities between IMRT and 3DCRT arm Our study shows that technique of radiation (3D-CRT and IMRT) affects QoL in HNSCC, treated radically. Though there was no difference in terms of acute toxicity in between groups but IMRT did significantly better considering dryness of mouth and sticky saliva, not only during treatment but at 3 months after completion of treatment. More number of patients and long term follow up is required to validate theses findings. This is an ongoing study in our department. during RT. Conclusion