S551
Clinical – Head & neck
ESTRO 2026
Conclusion: In this retrospective cohort of HPV+ OPSCC, prognostic value of TNM8-stage and treatment modality on OS was confirmed. Patients treated with CCRT had better OS than patients treated with RT or RT+EGFRI, consistent with current literature [1-2]. Smoking status is also of prognostic value, with current smokers exhibiting higher mortality rates than ex-smokers. References: 1. Mehanna, Hisham, et al. "Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De- ESCALaTE HPV): an open-label randomised controlled phase 3 trial." The Lancet 393.10166 (2019): 51-60.2. Gillison, Maura L et al. “Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial.” Lancet (London, England) vol. 393,10166 (2019): 40-50. doi:10.1016/S0140-6736(18)32779-X Keywords: prognostic factors, HPV+ oropharyngeal cancer Correlation between neutrophil-to-lymphocyte ratioand mucositis severity at peak toxicity in head and neck cancer patients undergoing radiotherapy Bianca Santo 1 , Matteo Romanello 2 , Giulia Lezzi 3 , Maria Cristina Barba 1 , Elisa Cavalera 1 , Elisa Ciurlia 1 , Paola De Franco 1 , Sara De Matteis 1 , Giuseppe Di Paola 1 , Angela Leone 1 , Antonella Papaleo 1 , Donatella Russo 1 , Antonio Palumbo 2 , Angela Sardaro 1 1 Radiotherapy, "Vito Fazzi" Hospital, Lecce, Italy. 2 Otorhinolaryngology,Head and Neck Surgery, "Vito Fazzi" Hospital, Lecce, Italy. 3 UOC Radiotherapy, Istituto Oncologico Veneto, Padova, Italy Purpose/Objective: The neutrophil-to-lymphocyte ratio (NLR) is a systemic inflammation marker reflecting the balance between innate and adaptive immunity. In head and neck cancer (HNC), acute mucositis represents a major dose-limiting toxicity during concurrent Digital Poster 847 chemoradiotherapy (CRT), contributing to treatment interruptions and long-term swallowing dysfunction. This study assessed the relationship between NLR and clinical/functional mucosal toxicity at the time of peak toxicity (T3). Material/Methods: Patients with locally advanced HNC treated with definitive CRT were prospectively evaluated. For each patient, NLR was calculated at baseline (T0), mid- treatment (T3, peak toxicity), and treatment completion (T6). Mucositis severity was scored using
patients alive at last follow-up was 57 months (range 8–202). 5-year OS was 78%, 5-year LRC was 91%, and 5-year DM-free interval was 90%. At univariable regression analysis, risk of death increased with number of smoked PY (HR 1.013 per PY, 95%CI 1.003- 1.023 and age (HR 1.053 per year, 95%CI 1.025–1.083). Risk of death was higher for current smokers vs never- smokers (HR 2.23; 95%CI 1.11–4.49) and for current smokers vs ex-smokers (HR 2.02; 95%CI 1.09–3.74). Patients treated with CCRT had lower risk of death than patients treated with RT (HR 0.33; 95%CI 0.18– 0.60) or patients treated with RT+EGFRI (HR 0.35; 95%CI 0.14–0.92; Figure 1). HR of death did not differ between patients treated with RT+EGFRI vs RT (HR 0.89; 95%CI 0.37– 2.13).
Higher TNM8-stage and worse ECOG-PS also had negative impacts on OS (Stage II vs Stage I: HR 1.93; 95%CI 0.88-4.26), Stage III vs Stage I: HR 4.30; 95%CI 2.29-8.11) and ECOG-PS 2-3 vs ECOG-PS 0-1: HR 2.73; 95%CI 1.23-6.07). In multivariable regression analysis, only TNM8-stage, treatment modality, and smoking status were significantly associated with OS; only TNM8-stage and treatment modality were significantly associated with LRC; and only TNM8-stage was significantly associated with DM-free interval (Table 1).
Made with FlippingBook - Share PDF online