Abstract book - ESTRO meets Asia

S60 ESTRO meets Asia 2018

therapy (FSRT) are both equally effective options for salvage, with differing toxicity spectrums. FSRT also constitutes an attractive option for tumor boost in selected sites. Herein, we report our clinical experience with HNC treated with CyberKnife FSRT ( CK-FSRT). Material and Methods Patients were referred for FSRT after tumor board discussion. Only gross disease was treated with FSRT with 2-3 mm PTV margin. Data for HNC patients who were treated with CK-FSRT between 2012 to 2017 were collected prospectively, and included demographics, treatment indication, radiation therapy (RT) details, toxicity profile and outcomes. Results Forty cases were treated during this period. Of these, 26 patients (19 Males, 7 Females) with median age of 62.5 years received reirradiation for recurrence/ second primary. Median time interval between initial RT and re- RT was 17.8 months (Range: 1—174 months). All except 2 patients (46Gy and 50.4Gy) had earlier received a dose of 60-70 Gy to the reirradiated region. Dose schedule was 30 Gy in 5 fractions (Range 10Gy/ 1 fraction to 49Gy/7 fractions). Response evaluation at treated site at first follow up imaging showed reduction in 10/26 patients, stable disease in 1/26 patients, progression in 11/26 patients and in 4 patients follow up images were not available. Median follow up post FSRT was 9.8 months (range, 1--61.4 months). On subsequent follow up, 9/26 patients had local disease progression, 2/26 patients had metastatic disease, 2/26 patients died and 1 patient developed second primary in esophagus. One patient developed carotid blow out and was successfully salvaged with angioembolization. One patient was PEG tube dependent till last follow up at 4 months. No other CTCAE grade 3 toxicities were noted. Fourteen patients received definitive radiotherapy with conventional fractionation plus CK-FSRT boost. A dose regimen of 54 Gy in 27 fractions (5 fractions/week) + 15 Gy/3 fractions with FSRT was given. Median follow up period for this group was 24.7 months ( range 3.8—53.4months). At last follow up 11patients had complete response, 2 had locoregional progression and 1 had distant metastases. Conclusion FSRT is a viable option for reirradiation as well as boost in HNC with encouraging local control and survival outcomes. Toxicities can be limited with judicious patient selection. PO-152 Frequency of anxiety & depression among patients undergoing radiotherapy for head and neck cancer M. Uddin Karim 1 , A.N. Abbasi 1 , B.M. Qureshi 1 , N. Ali 1 , A. Hafiz 1 , B.M. Khaskheli 1 , M.H. Aga 1 , Y. Ahmed 1 , F. Shaukat 1 , M.A. Mansha 1 1 Aga Khan University Hospital, Oncology, Karachi, Pakistan Purpose or Objective Head and neck cancer is a major site of cancer in Pakistan. Radiation therapy (RT) is a useful treatment modality but has some side effects. Side effects poorly affect the quality of life causing treatment gaps leading to prolonged duration of RT treatment resulting in poor loco-regional control and survival outcomes. Although the physical side effects of RT have been well described in published reports, relatively few studies have evaluated psychosocial functioning among patients treated in this setting. Psychiatric complications, particularly anxiety and depression, are common in patients treated for head and neck cancer, and these can have a significant negative impact on quality of life. This study aims to determine the frequency of anxiety and depression in our population of patients receiving RT for primary head and neck cancer as there is scarcity of local data in this regard. It would help us to determine if the frequency and severity of anxiety and depression in our patients is similar to the west or not

so that appropriate strategies could be developed for management and prevention, thus maintaining quality of life of these cancer patients Material and Methods This was a prospective study carried out in section of Radiation Oncology, Department of Oncology, Aga Khan University Hospital, Karachi, from 1 st March 2016 till January 2017. Twenty-five patients with histologically proven head and neck cancer, receiving radiation therapy were enrolled in the study based upon the inclusion and exclusion criteria. Data recorded for chemotherapy, surgery and other demographic features. Patients were evaluated during and after completion of treatment at first follow-up by the investigator for the frequency of anxiety and depression by voluntarily completing brief self-reporting questionnaire of Aga Khan University Anxiety and Depression scale. Results This was a prospective study carried out in section of Radiation Oncology, Department of Oncology, Aga Khan University Hospital, Karachi, from 1 st March 2016 till January 2017. Twenty-five patients with histologically proven head and neck cancer, receiving radiation therapy were enrolled in the study based upon the inclusion and exclusion criteria. Data recorded for chemotherapy, surgery and other demographic features. Patients were evaluated during and after completion of treatment at first follow-up by the investigator for the frequency of anxiety and depression by voluntarily completing brief self-reporting questionnaire of Aga Khan University Anxiety and Depression scale. Conclusion The frequency of anxiety and depression among patients undergoing radiation therapy for primary head and neck cancer was found to be high (52 %). At first follow-up, it was found to be 16%. There was higher incidence among patients who had surgery and chemotherapy along with radiation therapy for head and neck. Based on these results, study has been extended and further data is being collected from a larger number of patients to obtain more statistically reliable results. PO-153 Two Phase IMRT vs SIB IMRT in locally advanced head and neck cancers with concurrent chemotherapy S. Hunugundmath 1 , S. Basu 1 , B. Zade 1 , V.K. Sathiyanarayanan 2 , A. Nirhali 2 , P. m 2 , M. Munshi 1 1 Ruby Hall Clinic, Radiation Oncology, Pune, India 2 Ruby Hall Clinic, Medical Physics, Pune, India Purpose or Objective Locally advanced head and neck cancers can be treated with either 2 phase IMRT or SIB (Simultaneous integrated boost) IMRT. We tried to look into the treatment related outcomes including survival and acute and late toxicities between both the techniques. Material and Methods It was a single institute retrospective analysis on patients with locally advanced head and neck cancers (LAHNC) treated with definitive chemoradiotherapy OF weekly cisplatin. Treatment was delivered via 2 Phase IMRT (n=20) and SIB IMRT(n=20). The total dose delivered in 2 phase IMRT was 70Gy in 35 fractions. In Phase 1 PTV elective was given 50Gy in 25 fractions followed by PTV boost of 20Gy in 10 fractions. The SIB IMRT had PTV elective of 54Gy in 30 fractions, and PTV boost of 66Gy in 30 fractions. included total dose of 66Gy in 30 fractions. Contours, plan evaluation, and toxicity assessment were performed for all the patients. Toxicities were graded weekly during treatment and at 3-month follow up intervals. Recurrence-free survival, disease-free survival, and overall survival were estimated via Kaplan-Meier statistical method.