Abstract book - ESTRO meets Asia

S63 ESTRO meets Asia 2018

gamma camera NuclineTM X-Ring (Mediso, Hungary) in the "whole body" mode and, in addition, for scanning of the neck projection in "thyroid" mode was performed. Results 18FDG-PET/CT has a high sensitivity in detecting tumor progression (89%) and significantly superior to 131 I-WBS, p <0.001. The predictive value of the negative result of 18FDG-PET/CT in 62% also significantly exceeds that of 131 I-WBS in 34%. Therefore, in the negative 18FDG-PET/CT, the presence of progression can be more confidently rejected than in the negative 131 I-WBS result. The predictive value of the positive result of 18FDG-PET/CT and 131 I-WBS was similar - 92% and 95%, respectively. Therefore, according to the positive results of 18FDG- PET/CT and 131 I-WBS, it is possible to assert with the same certainty the presence of progression. During follow-up the following types of tumor progression were identified: in 32 cases (34%) - isolated locoregional recurrence, in 34(36%) - isolated distant metastasis, in the remaining 29(30,5%) - a combination of locoregional recurrence with distant metastases. The sensitivity of 18FDG-PET/CT in detecting all types of progression was quite high and there was no statistically significant difference, p>0.05. For 131 I- WBS isolated distant metastasis is best reveals then other types of recurrence (p <0.05). 18FDG-PET/CT was superior to 131 I-WBS in the diagnosis of all three types of progression, p <0.05. Conclusion With similar specificity 18FDG-PET/CT is superior in sensitivity and accuracy to 131 I-WBS in the detection of DTC progression. The inclusion of 18FDG-PET/CT in the diagnostic algorithm of DTC patients during the monitoring of combined treatment allows to detect or exclude the presence of metastatic foci in 87% and to change the tactics of treatment and follow-up in 49% of cases. Structural and metabolic information of 18FDG-PET/CT and 131 I-WBS have an important complementary information, combined application of these diagnostic methods allows to significantly improve the diagnostic efficiency. PO-158 Clinical outcome of head and neck cancer treated with radical IMRT: An institutional report A.K. Patidar 1 , P.H. Hirapara 2 , N.A. Patel 1 , D.M. Murthy 3 , A. Kulshreshtha 1 , S. Nandeshwar 1 1 Shree D B Tejani cancer institute managed by lions canc er detection center trust, Radiation oncology, Surat, India 2 HCG Hospital Bhavnagar, Radiation Oncology, Bhavnagar, India 3 Shree D B Tejani cancer institute managed by lions canc er detection center trust, Radiation Physcis, Surat, India Purpose or Objective At present IMRT technique is standard of care for radiotherapy in head and neck carcinoma. IMRT is becoming gradually available to smaller cities of developing countries also. We are presenting clinical outcome of head and neck squamous cell carcinoma (HNSCC) patients treated radically with Intensity- modulated radiotherapy (IMRT). Material and Methods One hundred and five HNSCC patients were retrospectively analyzed after approval of ethics committee. These patients were treated with IMRT from May 2014 to December 2016. Institutional radiation dose prescription was 70 Gy in 35 Fractions over 7 weeks with or without weekly concurrent cisplatin chemotherapy. Radiation toxicities and disease control (local control-LC, locoregional control- LRC, distant metastasis free survival- DMFS & Overall survival-OS) were evaluated. Results There were 88 male and 17 female patients; median age was 55 years (13-90 years). Distribution of primary disease

sites were nasopharynx, oropharynx, hypopharynx, larynx and oral cavity in 10.4, 23.8, 30.4, 23.8 & 11.4 % patients respectively. Approximately 87 % (III- 30.4% & IV- 56.2 %) patients are presented with locoregionally advanced stage. Mean radiation dose was 68.7 Gy (60-70 Gy), median radiotherapy duration was 55 days (41-88 days). Fifty-six patients did not receive neoadjuvant chemotherapy (NACT) while 49 patients received NACT. Twenty-nine patients received only radiotherapy while 76 patients received weekly concurrent chemotherapy (1-4 cycles: 54%, ≥5 cycles 46%). Most of patients (71.5%) had ≤10 % weight loss while 28.5% patients had weight loss >10 %. Only 10 patients had Grade III acute skin toxicity while 51 patients had severe acute mucosal toxicity (Grade III: 48 & IV: 3 patients). Median follow-up was 20 months (4- 46 months) and three patients were lost of follow- up. Response assessment done at three month showed CR (complete response) in 77.1% patients while 16.3% patients with PR (partial response) and 6.5% patients with SD (stable disease)/ PD (progressive disease). Skin, mucosal and subcutaneous chronic toxicity of grade 0-II & grade III-IV were in 96.6% & 3.4%, 86.6% & 13.4% and 90% & 10% patients respectively. 50% patients had grade ≥2 xerostomia (recorded at 6 month of follow-up) while none of them had oesteoradionecrosis or mylopathy till last follow-up. Loco-regional failures occurred in 27 patients while two patients failed at distant sites. Three year actuarial estimates of LC, DMFS, LRC & OS were 64%, 96%, 64 % and 60 % respectively. Conclusion Definitive treatment of the head and neck cancer with IMRT is feasible. Acute toxicities were manageable and 3- year outcomes were comparable and within the ranges of published series. PO-159 Weight loss in nasopharyngeal cancer mainly to be associated with pre-treatment dental extraction. S. Benkhaled 1 , T. Dragan 1 , S. Beauvois 1 , A. De Caluwe 1 , F. Charlier 1 , D. Van Gestel 1 1 Jules Bordet, Department of Radiotherapy, Université Libre de Bruxelles- Bruxelles, Belgium Purpose or Objective Treatment of naso-pharyngeal carcinoma (NPC) consists of radiotherapy alone (stage I) or radiotherapy concomitant with chemotherapy (stages II to IV). Management of acute side effects constitutes a major challenge for practitioners. Although ample literature is available from endemic areas, data emerging from Europe is lacking . This study examined epidemio-clinical characteristics, therapeutic results, acute side effects and weight changes of patients treated at the Jules Bordet Institute. Material and Methods Twenty-two non-metastatic NPC patients treated between May 2012 and September 2015 were retrospectively analyzed. All patients were treated by Intensity Modulated Radiation Therapy (IMRT) with or without chemotherapy. Toxicity was consistently graded by the same radiation oncologist. Results Thirteen patients (59%) have north african ancestry while nine are from european origin. Median age at diagnosis was 46.5 years. Seventy-three percent had a non- keratinizing carcinoma and 90% had advanced stage disease (stage III-IVb). Ninety-five percent received concomitant chemotherapy. After a median follow-up time of 31 months, overall survival at 3 years was 77%. Local, regional and distance control rates were 95%, 86% and 73%, respectively. The observed acute grade 3 toxicities were dysphagia (68%), mucositis (64%) and dermatitis (23%). Only one patient developed grade 4 dermatitis, requiring treatment discontinuation in the sixth week. In the seventh week of treatment 86% of the patients had lost more than 10% of their starting weight