S544
Clinical – Head & neck
ESTRO 2026
Oncology, JIPMER, Pondicherry, India. 5 Biostatistics, JIPMER, Pondicherry, India Purpose/Objective: Globally, 60–70% of patients with head and neck cancer present with advanced, incurable disease. Surgical management is often limited by disease extent, while chemotherapy is associated with considerable toxicity. Palliative hypofractionated radiotherapy offers symptom relief, shorter treatment duration, and better compliance. (1) In a single-arm study using 52.5 Gy in 15 fractions, the median survival was 5.1 months with a 47% overall response. (2) We hypothesised that adding concurrent chemotherapy could improve outcomes. However, concurrent cisplatin may cause severe toxicity in frail patients. (3) Capecitabine, an oral 5-FU prodrug activated within tumour tissue, offers effective radiosensitisation with lower toxicity. (4) We therefore conducted an open-label randomised trial comparing hypofractionated palliative radiotherapy with or without concurrent capecitabine. Material/Methods: Eligible patients (18–75 years, ECOG 2–3, cT4a/b,N1– 3,M0 head and neck cancers treated with palliative intent) were randomised (1:1) using SNOSE. During radiation, the intervention arm received concurrent oral capecitabine 500 mg/m2 twice dailywith 52.5 Gy/15 fractions (59 Gy EQD2; α / β =10). The primary endpoint was median progression-free survival; secondary endpoints included overall survival, response, toxicity, enteral feeding requirement, and compliance. Results: 100 patients were randomised to receive concurrent chemoradiotherapy (C-RT; n = 51) or radiotherapy alone (RT; n = 49). 16 patients in the C-RT and 12 in the RT arm died before treatment initiation. 2 patients in the RT arm declined treatment. Ultimately, 35 patients in the C-RT and 35 in the RT arm completed the planned treatment. A modified intention-to-treat analysis was performed. Baseline characteristics were comparable.There were 52 events —25 in C-RT and 27 in RT arm. On mITT, progression-free survival did not differ significantly between groups (HR 1.23; 95% CI 0.71–2.11; p = 0.459). Median PFS was 7.0 months (95% CI 5.8–8.2) in CRT and 9.0 months (95% CI 5.8– 12.2) in the RT arm (p = 0.957).There were 55 deaths — 25 in the C-RT arm and 30 in the RT-alone arm. On mITT, overall survival did not differ significantly between groups (HR 1.23; 95% CI 0.71–2.11; p = 0.459). Median survival was 10.0 months (95% CI 6.7– 13.3) in Arm A and 11.0 months (95% CI 7.1–14.9) in Arm B (p = 0.440). The secondary objectives are given in Fig.1.
Conclusion: The addition of concurrent capecitabine to hypofractionated palliative radiotherapy did not result in a statistically significant improvement in progression-free or overall survival compared to radiotherapy alone References: 1. Corry J, Peters LJ, et al. The “QUAD SHOT”: a phase II study of palliative radiotherapy for incurable head and neck cancer. Radiother Oncol. 2005;77(2):137–142.2. Veluthattil AC, Sudha SP, et al. Effect of hypofractionated palliative radiotherapy on quality of life in late-stage oral cavity cancer: a prospective clinical trial. Indian J Palliat Care. 2019;25(3):383–390.3. Jacinto AA, Batalha Filho ES, et al. Feasibility of concomitant cisplatin with hypofractionated radiotherapy for locally advanced head and neck squamous cell carcinoma. BMC Cancer. 2018;18(1):1026.4. Jegannathen A, et al. Synchronous chemoradiotherapy using capecitabine in locally advanced head and neck cancer: a phase II study. Clin Oncol. 2011;23(2):149–158. Keywords: concurrent, palliative hypofractionated, radiation Survival outcomes of radiotherapy alone versus concurrent chemoradiotherapy in T1-2 head and neck cancer with low-volume disease: a multicenter study Chuanhao Zhang 1,2 , Zhichao Cheng 2 , Xin Jiang 3 , Ye Zhang 4 , Ruoyu Wang 2 , Zhe Wang 2 1 Graduate School, Dalian Medical University, Dalian, China. 2 Department of Medical Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China. 3 Department of Radiation Oncology, the First Hospital of Jilin University, Changchun, China. 4 Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Poster Discussion 680
Purpose/Objective: The optimal treatment strategy between definitive
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