ESTRO 36 Abstract Book

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S571 ESTRO 36 2017
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Conclusion
Despite significance in the logistic regression, proportions
of patients receiving over 40Gy to the spinal cord were
low, and similar in both patient groups. Cisplatin did not
increase risk of LS. Other factors may be important and
our results suggest age and unilateral treatment may also
be key factors, possibly due to axial dose gradient across
the spinal cord. Further work will focus on relationships
between dose gradient and LS risk, and whether
metformin could be neuroprotective in head and neck
cancer patients undergoing radical radiotherapy.
EP-1041 The Preliminary Report of PG2 in Improving
QoL of Pharyngeal Cancer Patients in
Chemoradiotherapy
H.M. Wang1, J.R. Lin2, C.H. Hsieh1, C.L. Hsu1, C.Y. Lin3,
J.T.C. Chang3
1 Chang Gung Memorial Hospital, Division of Medical
Oncology- Department of Internal Medicine, Taoyuan,
Taiwan
2 Chang Gung University, Clinical Informatics and Medical
Statistics Research Center and Graduate Institute of
Clinical Medicine, Taoyuan, Taiwan
3 Chang Gung Memorial Hospital, Department of
Radiation Oncology, Taoyuan, Taiwan
Purpose or Objective
Concurrent chemoradiation (CCRT) is the current standard
of care for patients with locally advanced squamous cell
carcinoma (SCC) of head and neck. This therapy can
interfere the basic functions, including eating and speech,
and can have a profound effect on social interactions and
psychological state. PG2 (PhytoHealth Corporation,
Taiwan, ROC), extracted, isolated and purified from the
root of Astragalus (Huang-Chi), is the first TFDA NDA-
approved botanical new drug for alleviating cancer-
related fatigue and for the treatment of low energy level,
low WBC counts, deteriorated quality of life, and an
impaired immune function among cancer patients
undergoing chemotherapy. To investigate the effect of
PG2 for the reduction of the toxicities and deteriorated
quality of life (QoL) and even increase the compliance of
CCRT among advanced pharyngeal or laryngeal SCC
patients receiving CCRT, the double-blind, randomized
and placebo controlled trial was conducted.
Material and Methods
Advanced pharyngeal or laryngeal SCC pati ents were
recruited and randomly assigned to receive either CCRT
with PUL regimen (cisplatin/tegafur plus
uracil/leucovorin) plus 500 mg PG2 t.i.w by IV infusion or
CCRT with PUL plus placebo (normal saline) by IV
infusion.
Results
The study was early termination after 17 patients
completed the study due to the development of new
formulation of PG2. Among these patients, a noticeably
higher proportion of patients in PG2 group did not exhibit
predefined clinical significant deterioration in HN pain,
appetite loss, social eating, feel ill, physical functioning,
role functioning, insomnia, swallowing, nausea/vomiting,
and pain domains of QoL assessment by EORTC-QLQ-C30
and HN35 compared to the Control group (HN pain: 100%
vs. 29%; appetite loss: 60% vs. 0%; social eating: 60% vs.
0%; feel ill: 60% vs. 14%; physical functioning: 100% vs.
57%; role functioning: 80% vs. 43%, insomnia: 80% vs. 43%;
swallowing: 60% vs. 29%, nausea/vomiting: 60% vs. 29%,
and pain: 60% vs. 29%). No difference in tumor response,
CCRT compliance, and adverse events was observed.
Conclusion
PG2 is safe and has the potential role as a complementary
treatment to improve quality of life during CCRT for
patients with advanced pharyngeal or laryngeal SCC.
EP-1042 Olfactory neuroblastoma – 10-year
experience with VMAT radiotherapy
H. Ariyaratne1, A. Ward1, P. Bhudia1, V. Lund2, D.
Carnell1
1University College London Hospital NHS Trust, Clinical
Oncology, London, United Kingdom
2Royal National Throat Nose and Ear Hospital,
Professorial Unit, London, United Kingdom
Purpose or Objective
Olfactory neuroblastoma is an unusual head and neck
tumour arising from neuroectodermal cells. Localized
disease is best managed with combined modality
treatment with surgery and radiotherapy. Treatment is
challenging due to the location of tumours around the
cribriform plate. The majority of previously reported
series of patients were treated with conformal
radiotherapy. We report our experience in using
volumetric modulated arc treatment (VMAT) with
concurrent chemotherapy, in the management of this
tumour.
Material and Methods
We retrospectively reviewed the records of patients with
olfactory neuroblastoma treated at University College
London Hospital between Aug 2006 and June 2016.
Patients were treated by a specialist sinonasal surgeon and
clinical oncologist, in a tertiary referral centre.
Radiotherapy was inverse-planned and delivered using
RapidarcTM VMAT. The planning constraints used included
DMax 55 Gy for brainstem, and DMax 50 Gy for optic nerves
and chiasm. A dose of 60 – 65 Gy in 30 fractions was
delivered to the target volume. Induction chemotherapy
was used for bulky disease. Concurrent platinum-based
chemotherapy was administered to patients during
radiotherapy. Acute toxicity was assessed using the CTCAE
grading system. Kaplan-Meier survival analysis was used
for the whole group.
Results
17 patients treated with VMAT radiotherapy were
included. The median follow-up of patients was 43
months. The median age was 57 years (range 22 – 75
years). 53% were male. The Kadish stage distribution was:
4 patients had stage A, 3 patients had stage B, 7 patients
had stage C, and 3 patients stage D disease.13 patients
had endoscopic surgery and 3 patients had open
craniofacial resection. One patient had unresectable
disease. The majority of patients received concurrent
cisplatin chemotherapy. Even with inverse-planned
treatment, radiotherapy constraints for the optic
apparatus were not met in many patients, due to the
proximity of organs at risk. There was no acute grade 3/4
toxicity, and no long-term visual or neurological toxicity
during the period of follow-up. 5-year overall survival of
patients in this series was 83%.
Conclusion
VMAT radiotherapy with concurrent chemotherapy for
olfactory neuroblastoma is well-tolerated. Overall survival
of patients with olfactory neuroblastoma is good after
multi-modality treatment.
EP-1043 Chemo-reirradiation with simultaneously
integrated boost in patients with local recurrence of
HNSCC
A. Mikhaylov1, N. Vorobyov1,2,3, E. Sokolova4, G. Andreev5,
A. Kalesnik5, A. Lyubinskiy5, M. Rukhlenko6, V. Sokurenko7
1Dr. Berezin Medical Center, Radiation Therapy, Saint-
Petersburg, Russian Federation
2Saint-Petersburg State University, Oncology
department, Saint-Petersburg, Russian Federation
3North-western State Medical University named after
I.I.Mechnikov, Oncology department, Saint-Petersburg,
Russian Federation
4Dr. Berezin Medical Center, Oncology department,
Saint-Petersburg, Russian Federation
5Dr. Berezin Medical Center, Medical Physics