S545
Clinical – Head & neck
ESTRO 2026
1 Clinical Trial and Statistics Unit, The Institute of Cancer Research, London, United Kingdom. 2 Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. 3 Molecular Radiotherapy Unit, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom. 4 brainstrust, brainstrust, Cowes, United Kingdom. 5 Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom. 6 Department of Clinical Oncology, Mount Vernon Cancer Centre, Northwood, United Kingdom. 7 Department of Oncology and Radiotherapy, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom. 8 Department of Clinical Oncology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. 9 Head and Neck Unit, The Royal Marsden Hospital, London, United Kingdom. 10 Department of Clinical Oncology, Velindre Cancer Centre, Cardiff, United Kingdom. 11 Department of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. 12 Department of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom. 13 Department of Speech, Voice and Swallowing, The Royal Marsden NHS Foundation Trust, London, United Kingdom. 14 Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom. 15 National Radiotherapy Trials Quality Assurance (RTTQA) Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom. 16 Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom Purpose/Objective: The phase 3 randomised, controlled, TORPEdO trial investigated patients with locally advanced oropharyngeal squamous cell carcinoma (OPSCC), allocated between intensity-modulated proton therapy (IMPT) and intensity-modulated radiation therapy (IMRT) [1]. The trial showed no difference in long-term gastrostomy dependence or severe weight loss, or patient-reported physical quality of life or swallow function. Here we present analyses of secondary patient-reported outcomes. Material/Methods: In this trial participants with OPSCC requiring definitive bilateral chemoradiation were assigned in a 2:1 ratio to IMPT or IMRT (70 Gy (RBE) in 33 once daily fractions over 6.5 weeks), with two cycles of concurrent cisplatin chemotherapy (every 3 weeks, 100mg/m2). Health- related quality of life (HR-QoL) was collected using the University of Washington Quality of Life (UW-QoL), M.D. Anderson Dysphagia Inventory (MDADI), EORTC Quality of Life Questionnaire (EORTC QLQ-C30) and EORTC Quality of Life Head and Neck Module (EORTC QLQ-HN43) questionnaires at baseline, end of
radiotherapy and concurrent chemoradiotherapy (CCRT) for patients with T1-2 head and neck cancer with low-volume nodal disease remains unclear due to limited supporting data. This study aimed to compare overall survival (OS) and progression-free survival (PFS) between the two treatment modalities. Material/Methods: Patients with AJCC 7th edition stage T1-2N1-2a head and neck squamous cell carcinoma (HNSCC) were collected from multiple research centers, including the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (NCC), the University Health Network (UHN), and Quebec, Canada. Inverse probability of treatment weighting (IPTW) was applied to balance baseline differences. Kaplan-Meier analysis and Cox proportional hazards models were used to compare OS and PFS between the two groups. Results: A total of 240 patients were included, with a median age of 57.8 years (IQR 52.0-65.1); 51 patients (21%) were HPV-negative. After IPTW adjustment, multivariable Cox analysis showed that CCRT did not provide a significant OS benefit compared with radiotherapy alone (hazard ratio [HR], 0.50; 95% CI, 0.20-1.24; P = 0.14). However, CCRT was associated with a significant improvement in PFS (HR, 0.42; 95% CI, 0.19-0.93; P = 0.03). The NRG-HN002 trial further showed a 9.7% absolute reduction in locoregional failure with CCRT relative to radiotherapy alone. Conclusion: This multicenter study demonstrated that while CCRT conferred limited OS benefit in patients with stage T1- 2N1-2a HNSCC, it improved tumor progression control in a subset of patients. Careful evaluation of survival benefit versus treatment-related toxicity is warranted, and larger prospective studies are needed to validate these findings. References: None Keywords: Low-volume disease, Radiotherapy Health-related quality of life in the phase III trial of Toxicity Reduction using Proton Beam Therapy for Oropharyngeal Cancer (TORPEdO; CRUK/18/010) Matthew Tyler 1 , David J Thomson 2 , James Price 2 , Matthew Beasley 3 , Helen Bulbeck 4 , Frances Charlwood 5 , Kevin Chiu 6 , Judith A Christian 7 , Matthew Clarke 5 , Clare Cruickshank 1 , Deborah Gardiner 1 , James Lester 8 , Matthew M Lowe 5 , Christopher M Nutting 9 , Nachiappan Palaniappan 10 , Robin Prestwich 11 , Shanmugasundaram Ramkumar 12 , Justin Roe 13 , Anna Thompson 14 , Holly Tovey 1 , Justine Tyler 15 , Catharine M.L. West 16 , Emma Hall 1 Proffered Paper 696
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