S567
Clinical – Head & neck
ESTRO 2026
Cognitive Behavioral Therapy for Depression and Anxiety, Response Rates and Adverse Events in Patients with Locoregional Advanced Nasopharyngeal Carcinoma. Integrative cancer therapies 2021, 20:15347354211006179. Keywords: HNSCC, CBT, Depressive and Anxiety Symptoms
depressive and anxiety symptoms in patients with locally advanced HNSCC treated with concurrent chemoradiotherapy (CCRT). Material/Methods: A total of 226 patients with nonoperative (unresectable or surgery-declined) LA-HNSCC(T3-4b, N0-3, M0 oral cavity, oropharynx, hypopharynx and larynx) were randomly assigned in a 1:1 ratio to receive either CBT plus CCRT (CBT group, n = 113) or treatment as usual (TAU) plus CCRT (TAU group, n = 113). All patients underwent cisplatin-based CCRT. Intensity-modulated radiation therapy (IMRT) was administered at a radical dose of 70.0 Gy/35 fx to the primary tumor volume. In the CBT group, patients received six weekly CBT sessions integrating behavioral, cognitive, and educational strategies during CCRT. Acute toxicities were evaluated according to the CTCAE version 5.0. Depression and anxiety symptoms were assessed via Hospital Anxiety and Depression Scale (HADS) at baseline, CCRT completion, and 3-month post-CCRT. This trial was registered on chictr.org.cn (ChiCTR2300079205). Results: The CBT group demonstrated significantly lower rates of severe (grade ≥ 3) toxicities versus TAU: weight loss(2.7% vs 11.5%; p=0.021), fatigue (4.4% vs 13.3%; p=0.019), insomnia (3.5% vs 14.2%; p=0.010), oral mucositis (40.7% vs 69.0%; p<0.001), xerostomia (4.4% vs 14.2%; p=0.012), dysphagia (8.0% vs 17.7%; p=0.029), anemia (0% vs 5.3%; p=0.029), and hypoalbuminemia (0% vs 6.2%; p=0.014). No grade 5 toxicity occurred. From week 4 of RT to 3 months after RT completion, Patients in the CBT group exhibited significantly lower HADSdepression (HADS-D) and HADS-anxiety (HADS-A) scores (P < 0.01). Treatment response remained comparable between groups for objective response rate (ORR, 97.3% vs 95.6%; p=0.719), complete response (CR, 88.5% vs 86.7%; p=0.686), partial response (PR, 8.8% vs 8.8%; p=1.000), and stable disease (SD, 2.7% vs 4.4%; p=0.621).No progression disease (PD) occurred in either group. Conclusion: The integration of CBT with CCRT significantly reduced severe acute toxicities (including weight loss, fatigue, insomnia, oral mucositis, dry mouth, dysphagia, anemia and hypoalbuminemia), and alleviated depressive and anxiety symptoms in patients with locally advanced HNSCC, while maintaining equivalent therapeutic efficacy. References: 1.He LL, Xiao S, Jiang CH, et al: A randomized, controlled trial to investigate cognitive behavioral therapy in prevention and treatment of acute oral mucositis in patients with locoregional advanced nasopharyngeal carcinoma undergoing chemoradiotherapy. Frontiers in oncology 2023, 13:1143401.2.Liu F, Fu SN, Chen YZ, et al: Effects of
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Matched-Pair Analysis of Adjuvant Versus Definitive Radiotherapy in Locally Advanced Pharyngeal and Laryngeal Cancers Linda AGOLLI 1 , Elidon Mici 2 , Christine Langer 3 , Ann- Katrin Exeli 1 , Leon Wendrich 1 , Sebastian Harth 4 , Christoph Arens 3 , Daniel Habermehl 1 1 Radiation Oncology, Justus-Liebig-University Giessen, Giessen-Marburg University Hospital, Giessen, Germany. 2 Maxillofacial Surgery, BG Hospital Berlin Trauma Centre, Berlin, Germany. 3 Otorhinolaryngology, Justus-Liebig-University Giessen, Giessen-Marburg University Hospital, Giessen, Germany. 4 Department of Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Giessen-Marburg University Hospital, Giessen, Germany Purpose/Objective: Patients with locally advanced squamous cell carcinoma (SCC) of the pharynx or larynx are commonly treated with either definitive radiotherapy (RT) with or without systemic therapy or primary surgery followed by adjuvant RT. Comparative outcome data between these two approaches remain limited, particularly when accounting for baseline confounding factors. This study employed a propensity score–matched analysis to compare survival outcomes, treatment-related toxicities, and recurrence patterns between these patients. Material/Methods: A retrospective review was performed of 309 patients with locally advanced SCC of the oropharynx, hypopharynx, or larynx treated at our institution. To minimize selection bias, 61 patients who underwent surgery with adjuvant RT were matched one-to-one with 61 patients treated with definitive RT. Propensity scores were generated using logistic regression incorporating tumour stage, nodal stage, and age. Additional factors including Karnofsky performance status, comorbidities, smoking and alcohol use, tumour site, HPV/p16 status, and concurrent systemic therapy were compared post-matching to confirm balance. Outcomes included overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), metastasis-free survival (MFS), toxicities, and recurrence patterns. Survival analyses
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