ESTRO 36 Abstract Book

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S594 ESTRO 36
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Conclusion
Reirradiation in the H&N region with particle therapy gives
CBS-rates comparable to normo- or hyperfractionated
photon RT, and does not seem to increase in
hypofractionated schedules typically used in CIRT, in
contrast to what is reported in hypofractionated SBRT with
photons. The low number of events does not make it
possible to define significant risk factors or tolerance
doses for the CA.
EP-1080 Psychological distress in patients with head
and neck cancer during radiotherapy
M. Massaccesi1, L. Dinapoli1, A. Pesce1, R. Autorino 1, A.
Tenore1, M. Balducci1, D. Smaniotto1, G. Chiloiro1, M.
Rigante2, G. Cadoni2, G. Paludetti2, V. Valentini1, F.
Miccichè1
1 Università Cattolica del Sacro Cuore -Fondazione
Policlinico A. Gemelli, Radiation Oncology Department-
Gemelli ART, Rome, Italy
2 Università Cattolica del Sacro Cuore -Fondazione
Policlinico A. Gemelli, Institute of Otorhinolaryngology,
Rome, Italy
Purpose or Objective
The treatment of patients with head and neck (H&N)
cancer is usually complex and burdensome. Radical
radiotherapy (RT), which may follow surgery and be
combined with chemotherapy, usually lasts 6 to 7 weeks
and more than half patients can experience relevant acute
toxicity. Therefore the experience of receiving RT can be
both stressful and anxiety provoking. Aim of this study was
to evaluate the psychological distress of patients with H&N
cancer during RT.
Material and Methods
Consecutive patients with H&N cancer who underwent RT
with radical intent between January and September 2016
were included in this analysis. Psychological support was
available for all patients and Distress Thermometer (DT)
and Hospital Anxiety and Depression Scale (HADS) were
administered to evaluate emotional distress and mood,
respectively at the beginning (T0), after three-four weeks
(T1), and at the end (T2) of the RT course. Toxicity was
evaluated weekly by CTCAE version 4.0 criteria.
Results
Fifty patients (36 male and 14 female, mean age 61, range
14-82 years) were included. RT was post-operative in 22
patients (44.0%) and 25 (50.0%) patients received
concurrent CT.
At T0 evaluation, 32/50 patients (64.0%) were emotionally
distressed (cut off value DT score≥4) and 12/50 patients
(24%) showed anxiety/depression (cut off value HADS
score≥14). No difference was observed according to
previous surgery.
During RT, patients who were distressed (32/50) or
anxious and depressed (12/50) at the beginning of
treatment did not show any significant variation of their
DT score, while HADS score significantly improved at T2
evaluation (median HADS score 19 and 15, at T0 and T2
respectively, p=0.03). Patients who were not distressed
(18/50) or anxious and depressed (38/50) at baseline,
showed a worsening of DT score at both T1 (p=0.02) and
T2 (p=0.01) as compared to baseline; HADS score remained
substantially stable at T1 while worsened at T2 (p=0.03).
At T1, 9/40 (22.5%) evaluable patients had G≥3 acute
toxicity. Twenty seven/40 (67.5%) patients had significant
emotional distress and 9/40 (22.5%) patients had
significant anxiety and depression. Emotional distress was
more frequently observed among patients who were also
experiencing severe toxicity (77.7 versus 22.5%
respectively, p<0.01). These patients were also more
frequently anxious and depressed (55.5 versus 24.0%
respectively, p=0.08).
At T2, 10/34 (29.4%) evaluable patients had G≥3 acute
toxicity. Twenty five/34 (73.5%) patients had significant
emotional distress and 12/34 (35.3%) patients had
significant anxiety and depression. No significant
difference was observed according to severe toxicity
occurrence.
Conclusion
Patients with H&N cancer frequently experience
emotional distress and side effects of radiotherapy are
stressful and anxiety provoking events. Beside adequate
medical support, these patients also require focused
psychological interventions.
EP-1081 Tumor response after palliative radiotherapy
in head and neck cancer and its influence on survival
M. Cruz 1, C. Sousa1, D. Branco1, L. Khouri1, J. Brandão1, G.
Melo1
1Instituto Português de Oncologia de Coimbra, Radiation
Oncology, Coimbra, Portugal
Purpose or Objective
The aim of this study is to evaluate tumor response in Head
and Neck (H&N) cancer patients who underwent different
fractionation schemes of palliative radiotherapy (RT) and
its influence on overall survival.
Material and Methods
This is a retrospective unicentre study including patients
diagnosed with H&N cancer not suitable for curative
treatment. Those patients completed palliative
radiotherapy to primary local-regional sites in our
department between January 2013 and December 2015.
Radiation therapy was delivered using a mega-voltage
linear accelerator with 6 MV photons. Target volumes
generally included the gross tumor volume with 1 to 2 cm
margins. Tumor response patterns were evaluated
following a cervical and chest Computed Tomography (CT)
performed 4-6 weeks after RT.
Results
53 patients were included in this study (73.4% male). Mean
age was 71.3 years (±1.2). Primary tumor was localized in
oropharynx in 34% of the patients, oral cavity in 20.7% and
larynx in 18.9% of the patients. 92.4% of the tumors were