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6th ICHNO
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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and Dmax of IC and MDADI Score at 6 months; There’s
correlation between V30, V50, V60, V66, V70, Mean doses
of SGL and the PSSN Score at 6 months. For MDADI scores,
there’s a positive relationship of V30, V50, V60, V66, V70
and Mean of SGL and 6 month MDADI score.There is no
significant correlation between doses to GL and CE and
Scores. There is a high rate of baseline aspiration on
objective testing with Modified Barium Swallow.
In the brachytherapy group, D mean and D max and various
V d’s of the DARS were significantly lower than in the EBRT
alone group. This dosimetric analysis demonstrated
that brachytherapy can significantly reduce dose to DARS.
But more prospective trials are required to study
swallowing outcomes post Brachytherapy.
Conclusion
The findings of this study motivate further efforts beyond
IMRT to reduce the dose to the swallowing structures when
planning chemoradiotherapy for locally advanced head-
and-neck squamous cell carcinoma in cases where the
planning target volume does not overlap with DARS.
Use of Brachytherapy as a boost could spare significant
dose to the pharyngeal constrictors in such cases post
External Radiotherapy.
PO-129 managing the consequences of head and neck in
radiotherapy a Radiotherapy Late Effects clinic
J. Christian
1
, E. Stones
2
, E. Hallam
2
1
Nottingham University Hospital- Nottingham,
Department of Clinical Oncology, Nottingham, United
Kingdom
2
Nottingham University Hospital, Department of
Radiotherapy, Nottingham, United Kingdom
Purpose or Objective
Due to the rising number of patients’ now surviving head
and neck cancer, there are increasing number of patients
living with the long-term consequences of treatment.
Since October 2014, our hospital has run a fully
comprehensive Radiotherapy Late Effects (RTLE)
programme for all patients who are disease free but
suffering with the adverse late effects of their
radiotherapy treatment. At the centre of the programme
is an open access clinic, where patients can self-refer.
From there, patients can be given information about
managing their RTLE. For those with more severe
symptoms we have developed clinical pathways now
accessing a vast array of specialist interest clinical teams
within the hospital. This study assesses the patients
attending the RTLE clinic who have previously been
treated for Head and Neck cancer
Material and Methods
The database was reviewed for all patients who have
attending the RTLE clinic. Details of tumour location,
treatment details, time since treatment were recorded
alongside patient quality of life measures using a simple
modified Holistic Needs Assessment (HNA) tool that
identifies people’s concerns and needs from a score of 1 –
10, where 1 represents the lowest level of concerns and
10, the highest.
Patients were seen in the clinic by therapy radiographers,
their symptoms and difficulties discussed and HNA carried
out. Depending on the symptoms and the severity of the
presentation, patients were either given information
sheets pertinent to their specific late-effects or would be
advised to access one of the specialist pathways. HNA was
carried out at presentation to the clinic and then at
approximately 6 months later. Patients were required to
have completed RT more than 6 months prior to referral.
Results
From October 2014 – Sept 2016, 153 patients have been
seen the RTLE clinic. Of these, 45 patients had previously
been treated for Head and Neck cancer with a radical
dose. This group was larger than the prostate cancer
patient group within the clinic. 35.7% had received
treatment for oropharynx cancer, 28.6% for tongue
cancer, 14.3% for hypopharyngeal/larynx cancer. 39
patients had follow-up data available. Median time from
end of radiotherapy to clinic referral was (2.52 years).
Range 5.6 months – 30 years. 16/39 (41.0%) patients were
given general advice and information only. 23/39 (59.0%)
needed referral to a specialist team as described in Table
1. A total of 28 specialist team referrals were made, some
patients requiring more than one referral. Only 6 of the 28
referrals required going back into specialist medical
clinics. The mean HNA score at initial presentation was
7.28 and at follow-up the mean score had reduced to 4.72.
Table 1 Outcomes of the Radiotherapy Late Effects clinic
Conclusion
A RTLE clinic can provide an excellent support for people
suffering the consequences of the Head and Neck cancer
treatment. Giving advice and signposting patients to the
correct clinical pathways can reduce patients concerns
and provide a cost-effective management strategy that
does not necessarily involve medical appointments.
PO-130 Longitudinal assessment of enteral nutrition
requirement in 1st line treatment of SCCHN
M.N. Falewee (France), C. Michel, C. Hebert, E. Chamorey
1
Centre Antoine Lacassagne, Nutrition, NICE, France
2
Centre Antoine Lacassagne, Medical Writing, Nice,
France
3
Centre Antoine Lacassagne, Medical Oncology, Nice,
France
4
Centre Antoine Lacassagne, Biostatistics, Nice, France
Purpose or Objective
First line SCCHN patients can be treated by: surgery (S),
radiotherapy (RT), chemotherapy (C), radiochemotherapy
(RTCT), induction chemotherapy ± RTCT (IND), surgery +
RT, surgery + RTCT.
There is a lack of prospective data regarding nutritional
support necessity whatever treatment realized.
Material and Methods
This was a prospective study conducted in a single
institution from December 2012 to December 2014. The
aim was to evaluate enteral nutrition importance (rate,
length and occurrence) and outcomes over the first 18
months of treatment.
Results
Hundred and thirty-five patients have been enrolled: 22 in
the S group, 16 in the RT group, 3 in the CT group, 28 in
the RTCT group, 31 in the IND group, 11 in the surgery +
RT group, 23 in the surgery + RTCT group. EN was set up
before treatment in 11.8% of patients and the mean EN
length (SD) during this period was 20.4 (16.2) days.
From treatment start to 18 months after, 67.4% of patients
beneficiated from EN. The mean time (SD) of first support
set up was 73.3 (87.2) days. The total EN mean length (SD)
during the period was 133.7 (137.5). During the post
treatment period, EN was set up one time in 57 patients