ESTRO 38 Abstract book

S659 ESTRO 38

20%, G2 in 52% and G3 in 26% of the patients. At 3 months toxicity was G0 in 36%, G1 in 43%, G2 in 19% and G3 in 2% of the patients. Acute G3 was always mucositis, in the long FU the late maximum toxicity was G3 for 20 (15%) pts and G4 for 2 (1%) pts. There were no G5 events. Conclusion CNAO preliminary data show encouraging outcome results and acceptable toxicities but longer follow-up is needed. EP-1190 Preliminary evaluation of salivary cytokines in patients treated with IMRT for head and neck cancer A. Cavallo 1 , N.A. Iacovelli 2 , T. Rancati 3 , N. Facchinetti 2 , T. Di Florio 3 , V. Doldi 4 , E. Campi 4 , N. Zaffaroni 4 , T. Giandini 1 , L. Ferella 2 , D.A. Romanello 2,5 , C.T. Delle Curti 2,5 , P. Bossi 6 , E. Pignoli 1 , C. Fallai 2 , R. Valdagni 3,7,8 , E. Orlandi 2,8 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Medical Physics Unit, Milan, Italy ; 2 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiation Oncology 2, Milan, Italy ; 3 Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy ; 4 Fondazione IRCCS Istituto Nazionale dei Tumori, Molecular Pharmacology Unit, Milan, Italy ; 5 University of Milano- Bicocca, School of Medicine and Surgery, Milan, Italy ; 6 Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Unit, Milan, Italy ; 7 University of Milan, Department of Oncology and Hemato-oncology, Milan, Italy ; 8 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiation Oncology 1, Milan, Italy Purpose or Objective The role of salivary inflammatory markers and their early variation in predicting increased risk radiation-induced acute toxicities in head and neck cancer (HNC) patients (pts) is under investigation within a prospective observational clinical trial. Preliminary evaluation is here reported. Material and Methods A series of HNC pts curatively treated with intensity modulated RT (prescribed dose ≥66 and ≥54Gy for definitive and post-operative setting, respectively; 2-2.12 Gy/fraction; 5 fractions/week) with or without chemotherapy was considered. Saliva samples for inflammatory marker levels evaluation were collected before RT (T0) and in the third week (T1), i.e. between the 10 th and 15 th RT fraction. The concentration (pg/ml) of IL-1β and IL-6 cytokines was measured using ELISA assays. Acute toxicity profiles were assessed according to CTCAE v4.0 at baseline and weekly during RT. The following endpoints were considered: maximum oral mucositis (OM) grade (G)≥3, mean OM G≥1.5 during RT, maximum dysphagia G3 and maximum dry mouth G≥2. Early cytokines variation and its possible association with toxicity were evaluated with Wilcoxon signed-rank and Mann-Whitney tests, respectively. Results 81 pts were available for this analysis; only 73/81 had saliva samples collected for both time points. Collection of saliva at T1 was difficult in many cases, due to an already present salivary flow alteration in the third week of RT. OM G≥3 was reported in 27 pts (37%), mean OM G≥1.5 in 14 pts (19%), dysphagia G3 in 7 (10%) and dry mouth G≥2 in 60 pts (82%). Salivary levels of both cytokines significantly varied between T0 and T1 (p<0.001). Figure 1 reports marker level distributions and early changes after 2 weeks of RT. The variation in IL-1β and IL-6 concentration was: <0 pg/ml (i.e. decrease in concentration) for 12 and 13 pts, in the range 0-300 pg/ml (i.e. mild to moderate increase) for 42 and 52 pts, higher than 300 pg/ml (i.e. large increase) for 19 and 8 pts, respectively.

Maximum late tox was G0, G1, G2 for 3 (12.5%), 13 (54.2%), and 8 (33.3%) pts, respectively. No G3-G4 late tox was observed. Among pts with late tox, 11 (45.8%) had peripheral neuropathy (G1 and G2 in 8 (33.3%) and 3 (12.5%) pts, respectively). No patient experienced facial nerve damage as treatment-related tox. Conclusion In our experience, CIRT in recurrent pleomorphic adenoma pts has shown excellent local control and good toxicity profile. It might be a good alternative to invasive surgery especially when the latter is judged to be at high risk of facial nerve damage. However, a larger series of patients and a longer follow-up are needed to better investigate outcomes, especially in terms of late toxicity. EP-1189 Adenoid Cystic Carcinoma Of The Head And Neck Treated With Carbon Ion Radiotherapy At CNAO M. Bonora 1 , B. Vischioni 1 , D. Caivano 2 , A. Hasegawa 3 , V. Vitolo 1 , S. Ronchi 1 , E. D'Ippolito 1 , A. Iannalfi 1 , M.R. Fiore 1 , A. Barcellini 1 , R. Petrucci 1 , S. Russo 1 , S. Molinelli 1 , A. Vai 1 , G. Viselner 4 , A. Facoetti 1 , M. Ciocca 1 , L. Preda 4 , F. Valvo 1 , R. Orecchia 1,5 1 National Center of Oncological Hadrontherapy, Radiotherapy Unit, Pavia, Italy ; 2 University of Turin, Department of Oncology- Radiation Oncology, Turin, Italy ; 3 Osaka Heavy Ion Therapy Center, Radiation therapy Unit, Osaka, Japan ; 4 National Center of Oncological Hadrontherapy, Diagnostic Imaging Unit, Pavia, Italy ; 5 European Institute of Oncology, Radiation therapy Unit, Milan, Italy Purpose or Objective To evaluate preliminary results of carbon ion radiotherapy (RT) in patients (pts) with adenoid cystic carcinoma (ACC) of the head and neck (H&N) region treated with curative intent at the National Center for Oncological Hadrontherapy (CNAO) according to the phase II clinical study CNAO S9/2012/C. Material and Methods Between March 2013 and September 2016, 135 patients (M/F = 61/74) with ACC of the H&N were treated with active scanning carbon ion RT. Pts average age was 54 (range 19 – 82). Tumour site was minor salivary gland in 90 (67%) and major salivary gland in 45 (33%) pts. In 20 pts (15%) treatment was at disease recurrence, 115 (85%) pts were treated after first diagnosis. Before carbon ion RT, 83 (62%) pts received surgery, of these 60 (45%) pts had positive margins (R1), 13 (10%) pts had no status of margins on histological report, and 9 (7%) pts receveid debulking surgery (R2). No pts received previous RT. In all the cases prescribed total dose was of 68.8 Gy(RBE) in 16 fractions, 4 fractions/week. Toxicity was evaluated according to the CTCAE v.4.0. Pts were followed up every three months after RT with clinical evaluation and MRI. For all patients C11 methionine PET-TC was used for target delineation. Results Median follow-up time was 23 months (range: 1 – 51 months). Local Control was reached in 101 out of 135 (75%) patients, with 12 and 24-months local control rates of 91% and 81% respectively. The Progression-Free Survival at 12 and 24 months was 81% and 67%, respectively. The Distant Metastasis Free Survival at 12 and 24 months was 86% and 81%, respectively. Median overall survival (OS) time was 24 months and the rates of OS were 95% and 85% at 12 and 24 months respectively. At the end of treatment toxicity was G0 in 2%, G1 in