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6th ICHNO
page 37
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
__________________________________________________________________________________________
L. Deantonio
1
, M. Paolini
1
, E. Puta
2
, E. Ferrara
1
, L.
Vigna
3
, R. Matheoud
3
, G. Sacchetti
2
, M. Brambilla
3
, M.
Krengli
1
1
University Hospital Maggiore della Carità,
Radiotherapy, Novara, Italy
2
University Hospital Maggiore della Carità, Nuclear
Medicine, Novara, Italy
3
University Hospital Maggiore della Carità, Medical
Physics, Novara, Italy
Purpose or Objective
To evaluate the predictive significance of different
descriptive parameters in head-and-neck cancer
patients undergoing pretreatment [F18] FDG-PET
imaging
Material and Methods
Thirty-eight head-and-neck cancer patients who
underwent FDG-PET before a course of curative intent
radiotherapy were retrospectively analyzed. FDG-PET
imaging parameters included maximum (SUVmax), and
mean (SUVmean) standard uptake values, metabolic
tumor volume (MTV), and total lesion glycolysis (TLG). We
studied three threshold methods: the threshold of the 40%
of the maximum uptake value (SUV40%), the threshold of
the 50% of the maximum uptake value (SUV50%) and the
adaptive threshold algorithm (ATA) implemented on the
iTaRT workstation (Tecnologie Avanzate, Italy), this
algorithm used specific calibration curves that depended
on the lesion-to-background ratio (LB ratio) and on the
amplitude of reconstruction smoothing filter (FWH). The
correlation of SUV parameters with tumour
characteristics, treatment response, and survival were
analysed.
Results
Higher SUVmeanATA was associated to higher primary
tumour staging (p= 0.04). SUV parameters resulted not
predictive of tumour response. The TLG
ATA
was predictive
of local recurrence (p = 0.04) and MTV
ATA
of overall survival
(OS) (p= 0.04). SUVmax (ROC 0.8, p= 0.01) was predictive
of 2-year DFS.
Conclusion
This study suggests that the baseline [18F]FDG-PET/CT
parameters could predict recurrence risk and overall
survival in head and neck cancer patients treated with
chemoradiotherapy
Abstract submission: 6th ICHNO withdrawn
PO-077 Cisplatin or Carboplatin in locally advanced
head and neck squamous cell carcinoma
N. Bahie eldin
1
, N. Mosalem
1
1
Ain Shams University Hospital, clinical oncology, Cairo,
Egypt
Purpose or Objective
This single center open labelled randomized controlled
trial comparing concurrent chemoradiotherapy with
weekly cisplatin versus weekly carboplatin in patients with
locally advanced head and neck squamous cell carcinoma
Material and Methods
From march 2013 to december 2015 62 patients with
locally advanced head and neck squamous cell carcinoma
were randomized with 31 to cisplatin arm and 31 to
carboplatin arm planned radiotherapy was the same in
both groups all patients were evaluated for efficacy and
toxicity according to the as treated principle
Results
With a median follow up of 6 months
the acute non hematological toxicity in the form of renal
toxicity was significant in cisplatin ARM ( p=0.03)and
hematological toxicity in the form of neutropenia was
significant
in
carboplatin
arm
(p=0.001)
xerostomia as late toxicity was significant in carboplatin
ARM
(p=0.004)
the 2 years pfs was 10 months in cisplatin ARM and 6
months in carboplatin arm ( p=o.048)
Conclusion
We concluded that efficacy of weekly cisplatin is superior
to weekly carboplatin as part of CCRT moreover the
tolerability of weekly cisplatin regimen was acceptable
Poster: Innovative treatments
PO-078 The evaluation of the set-up differences
between radiation therapists for head and neck patients
E. Kara (Turkey), A. Yazici, B. Dirican, B. Boybas, M.A.
Gunaydin, A. Kartal, M. Akmansu, A. Hicsonmez
1
Onko
Ankara oncology center, Oncology Department, Ankara,
Turkey
2
Gulhane education and research hospital, radiation
oncology, Ankara, Turkey
3
Gazi university, radiation oncology, Ankara, Turkey
Purpose or Objective
The set-up accuracy is important in intensity modulated
radiation therapy (IMRT) to avoid the geographical misses
increasing the risk of recurrence. In radiation therapy the
set-up errors in the therapeutic fields are determined by
using portal imaging and cone beam computed
tomography (CBCT). The images obtained during
treatment are compared with the planning images to
verify the treatment fields. In this study, we try to figure
out the electronic portal images’ (EPI) evaluation
differences between the therapists in the reference of
CBCT.
Material and Methods
In this study, 62 EPI images belonging to 13 head & neck
patients treated in our department were evaluated
separately by 4 therapists as offline and the amount of
shift in the center of fields were determined. CBCT taken
at the same time with the EPI images were accepted as
reference and the amount of shift in the center of fields
were compared separately for each therapist with the
results of EPI.
Results
According to our results, the amount of shift in the center
of fields have changed between therapists with 0 mm to
9,4 mm in the reference of CBCT. The probability of
shifting center of fields to be greater than 3 mm were %60
for the first therapist, %35 for second therapist , %63 third
therapist and %50 fourth therapist. The probability of
shifting center of fields to be greater than 5 mm were 24%,
8%, 27% and 14.5%, respectively. ANOVA (analysis of
variance for repeated measures) test was applied to
center shift values by using SPSS program and there was
significant difference in the groups (sig. <0.05) and a
significant difference between the groups (sig. <0.05). The
degree of impact of the difference between the groups is
defined as statistically large.
Conclusion
This study that we have performed on 13 patients and 62
fractions due to figure out the evaluation differences of
EPI images between therapists have revealed the
importance of CBCT imaging in IMRT plannings having high
dose gradient. The usage of CBCT for the verification of
treatment fields eliminates the differences in
interpersonal evaluation. CBCT improve the set-up
accuracy such that PTV expansion margin can be safely
dropped. Therefore, CBCT should be the preferred
imaging modality in IMRT planning. Our results suggest