Abstract book - ESTRO meets Asia

S64 ESTRO meets Asia 2018

Purpose or Objective The adverse effects of radiation therapy, on the skin include severe acute and chronic dermatitis associated with pain, discomfort, itching, and burning, and may heavily affect patients’ quality of life. Acute skin toxicity is one of the side effects of radiotherapy on the skin which could occur throughout the treatment and ninety days after end of radiotherapy. This study proposed a management of the skin adverse effects by doing an acute skin toxicity assessment on every week of treatment to head and neck cancer patients who undergo the radiotherapy by Volumetric Modulated Arc Therapy (VMAT). This research is done with aim to study the effectiveness of acute skin toxicity assessment to avoid the acute skin toxicity from worsening. Material and Methods Forty patients presenting head and neck cancers who were treated with radical radiotherapy were analyzed. All patients were treated with VMAT-RapidArc. We included 29 male and 11 female patients with a median age of 58 years (range, 27–85). Median radiation dose was 62 Gy (range, 24–70.2 Gy). The acute skin toxicity grade was assessed according to RTOG on every week of treatment. Radiation therapist and nurse delivered a health education to all patients whether they have experienced acute skin toxicity or not. The patients scheduled for oncologist appointment on every week of treatment to gain the health education and receive the appropriate action based on the grade of toxicity. The oncologists prescribed the medication (a topical cream) for those patients who experienced Grade 2 and above. Results Seven (17.5%) patients have Grade 0, 24 (60%) patients have Grade 1, 6 (15%) patients have Grade 2 and 3 (7.5%) patients have Grade 3. Statistical analysis chi square was used to compare grade of acute skin toxicity obtained with other studies. There was a significant differences between this research with other studies (Table 1). The percentage of patients receive low grade of acute skin toxicity in this research is higher compared to other studies.

(Fig. 1). Univariate analysis identified three factors driving the weight loss: grade 3 mucositis of the soft palate (p=.027), vomiting (p=.019) and pre-treatment dental extraction (p=.006) (Table. 1). The degree of mucositis was influenced by the distance between the tumour and the soft palate (p=.024). In multivariate analysis weight loss is predominantly linked to dental extraction (p=.001). Late toxicities were predominantly xerostomia (68%), auditory symptoms (55%) and hypothyroidism (45%). Figure 1. Evolution of the weight of the first radiotherapy consultation (C) up to the last week of treatment.

Table 1. Univariate and multivariate analysis of factors influencing weight loss.

Table 1: Skin toxicity comparison with previous studies.

Conclusion In conclusion, acute skin toxicity assessment weekly throughout the treatment and the intervention done was potentially an effective management in reducing the acute skin toxicity among head and neck cancer patients. PO-161 Radiotherapy Dose Escalation in Primary Treatment of NPC: A Sytematic Review and Meta-analysis L. Co 1 Purpose or Objective Dose escalation in nasopharyngeal carcinoma remains underutilized despite significant advances in methods of radiation delivery. Brachytherapy, EBRT or SRT boost during primary treatment has been shown to improve local control rates, which could have an impact on survival. Our objective is to summarize the currently available evidence for dose escalation in nasopharyngeal carcinoma. 1 Benavides Cancer Institute- UST Hospital, Radiation Oncology, Manila, Philippines

Conclusion Our epidemio-clinical characteristics, outcome and toxicity are comparable to the data from endemic regions. Surprisingly, weight loss of >10% is correlated to pre- treatment dental extraction. This finding has to be confirmed and analyzed in a prospective manner. PO-160 Acute skin toxicity assessment among head and neck cancer patients treated with VMAT R. Ahmad 1 , N. Ismail 1 , M.N. Norfadilah 2 , N.A. Yahya 1 1 Faculty of Allied Health Siences Universiti Kebangsaan Malaysia, Programme of Diagnostic Imaging and Radiotherapy, Kuala Lumpur, Malaysia 2 Mount Miriam Cancer Hospital, Radiotherapy, Penang, Malaysia