S566
Clinical – Head & neck
ESTRO 2026
significantly larger than CT-based ones (median 31.4 cc vs. 17.4 cc; p = 0.01). Dice similarity coefficients (0.23– 0.83) and Hausdorff distances (7–38 mm) showed substantial variability between modalities. Tumor delineations also differed between surgeons and radiation oncologists: Mean difference of tumor volumes was 14.2 cc (p=0.82), but interobserver variability yielded a mean Dice coefficient of 0.63 ± 0.16 and a mean Hausdorff distance of 1.68 ± 0.8 cm. 24 (83%) patients received PORT. In 17% of cases, the routine high-dose PTV (66–70 Gy; according to the DAHANCA guidelines) was enlarged by the radiation oncologist based on positive MARBs. Conclusion: Interim data from the NAVIGATORR study indicate that navigation-guided resection combined with interdisciplinary planning of surgery and PORT is feasible. MRI seems to improve planning of surgical resection compared to CT alone. Moreover, the interdisciplinary collaboration and effective flow of information could lead to relevant changes in treatment decisions. Ongoing patient recruitment and follow-up will determine whether these advances translate into improved clinical outcomes. Keywords: midface cancer, navigation-guided, imaging Effects of CBT on Acute Toxicities, Depressive and Anxiety Symptoms in Patients with LA-HNSCC Undergoing CCRT: A Randomized, Controlled Clinical Trial Yuyi Li 1,2 , Feng Liu 1,2 , Hui Wang 1,2 , Huai Liu 1,2 , Cuihong Jiang 1 , Lili He 1 , Xu Ye 1 , Changgen Fang 1 , Yanfang Qiu 1,2 , Kailin Chen 1,2 , Shulu Hu 1,2 , Yanxian Li 1,2 , Qi Zhao 1 , Shuai Xiao 1 , Wenqiong Wu 1 , Xiangwei wu 1 , Wen Liu 1 , Weichang Zhu 1,2 , Xiaoyu Chen 1 , Chao Tan 1 , Xiaoyue Zhang 1 , Yuchen Shi 1 1 Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China. 2 Key Laboratory of Translational Radiation Oncology,Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China Mini-Oral 1423 Purpose/Objective: We hypothesized that the addition of cognitive behavioral therapy (CBT) to chemoradiotherapy would reduce the incidence of acute toxicities, depressive and anxiety symptoms in patients with nonoperative localregional-advanced head and neck squamous cell carcinoma (LA-HNSCC). This phase 2 randomized controlled trial aimed to evaluate whether concurrent CBT could reduce the incidence of acute toxicities,
quality of treatment and oncologic results in patients with midface tumors. Material/Methods: NAVIGATORR is a prospective clinical study planning to enroll 60 patients with locally advanced midface tumors. All patients undergo tumor resection using intraoperative optical navigation (Brainlab, Munich). Resection planning is performed by an interdisciplinary team comprising surgeons, radiologists, and radiation oncologists. All patients receive both MRI and CT imaging for preoperative assessment and radiation treatment planning. Preoperative tumor contouring is jointly performed by a maxillofacial surgeon and a radiation oncologist. During surgery, standardized marginal resection biopsies (MARBs) are obtained and their locations are recorded within the imaging data. For PORT, the radiation oncologist generates a treatment plan blinded to the MARB information (acc. DAHANCA guidelines). Thereafter, MARB locations are imported into the planning software and the radiation oncologist is given the opportunity to individualize target volumes accordingly.
Results: To date, 29 patients have undergone navigation- guided tumor resection. On average, 8 marginal resection biopsies (MARBs) were obtained per patient (range: 3–14). Comparison of MRI- and CT-based tumor contours by a radiologist prior to resection demonstrated that MRI-derived tumor volumes were
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