ESTRO 36 Abstract Book

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S590 ESTRO 36 2017
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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. Cruz1, C. Sousa1, D. Branco 1, L. Khouri1, J. Brandão1, G.
Melo1
1 Instituto 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
histologically classified as squamous cells carcinoma. At
the time of the diagnosis, 86.8% of the patients had stage
IV disease.
Mean Karnofksy Performance Status (KPS) was 68%.
RT palliative schemes chosen were 50Gy delivered in 20
fractions during 4 weeks (50Gy/20fr/4w) in 35% of our
patients, 30Gy/10fr/2w in 32%, 37.5Gy/15fr/3w in 18.9%
and 40Gy/20fr/4w in 13.2% of our patients.
After the analysis of cervical and chest CT, 61.2% of the
patients had partial response while 10.2% had complete
imagiologic response, 18.4% had imagiologic progression
and 8.2% had stabilised disease.
After a mean follow-up period of 27.2 months (±8,3),
overall survival was 9.55 months (±9,3).
The group with better tumor response on CT was the group
that underwent for the 50Gy/20fr/4w scheme (in which
89.4% had partial/complete response) with no need for
interruption of the treatment due to toxicity. The group
with longer overall survival was the group that underwent
for the 30Gy/10fr/2w (11.8 months) and the shortest
overall survival was verified after the 37.5Gy/15fr/3w
scheme (5.2 months). Despite these results, there were no
statistically significant differences between the four RT
schemes delivered to our patients and overall survival
(p=0.41).
Patients who had better tumor response on CT (partial or
complete response) had longer overall survival comparing
to patients who had stabilised disease or progression (11.6
months vs. 6.65 months; p=0,011).
Conclusion
There is no consensus regarding the choice of the optimal
RT fractionation scheme used in palliative care of H&N
cancer patients and careful patient selection. Patients
with advanced incurable H&N cancer have a poor
prognosis but the addition of palliative RT provides better
local-regional control of the disease with the possibility of
longer survival rates. More studies should be carried out in
order to evaluate predictive factors of tumor response as
a mean of improving patient’s outcomes and quality of
life.
EP-1082 Primary surgery vs. radiotherapy in early-
stage oropharyngeal cancer: a single centre experience
C. Pedro 1, B. Mira 2, P. Silva1, E. Netto3, R. Pocinho1, A.
Mota1, P. Pereira1, M. Ferreira2, T. Alexandre2, I.
Sargento2, P. Montalvão4, M. Magalhães4, S. Esteves5, F.
Santos1
1Instituto Português de Oncologia de Lisboa Francisco
Gentil- EPE, Radiotherapy Department, Lisboa, Portugal
2Instituto Português de Oncologia de Lisboa Francisco
Gentil- EPE, Oncology Department, Lisboa, Portugal
3NOVA Medical School UNL, Radiation Oncology, Lisboa,
Portugal
4Instituto Português de Oncologia de Lisboa Francisco
Gentil- EPE, Otorhinolaryngology Department, Lisboa,
Portugal
5Instituto Português de Oncologia de Lisboa Francisco
Gentil- EPE, Clinical Research Unit, Lisboa, Portugal
Purpose or Objective