S575
Clinical – Head & neck
ESTRO 2026
margins (n=15) and ENE (n=68). Field design was BNI in 52 and UNI in 25. No-TB was used in 53. Concurrent cisplatin was administered in 50. Median follow-up was 33.4 months (3.6–105). Recurrence occurred in 44 patients: local in 7, regional in 11, and distant in 37. Three-year CIRR was 11.5% for BNI and 21.0% for UNI, without a significant difference. Three-year LC was 81.4% with tumor-bed coverage and 94.1% with No- TB, also without a significant difference. In the entire cohort, three-year OS was 66.5% and PFS was 42.8%. On univariable and multivariable analyses, field design was not a significant risk factor for CIRR, LC, OS, or PFS.
IVa nasopharyngeal carcinoma receiving neoadjuvant chemotherapy combined with definitive intensity- modulated radiotherapy. Cancer Research and Treatment, 55(2), 609-619. https://doi.org/10.4143/crt.2022.1651 Keywords: Nasopharyngeal cancer, Chemotherapy, Response
Digital Poster 1748
Selective Postoperative Fields in Hypopharyngeal Cancer: Outcomes with Unilateral Neck Irradiation and Omission of the Tumor Bed Akikazu Kobori 1,2 , Madoka Sakuramachi 1 , Akane Yoshiba 1 , Shoki Nakamura 1 , Ayaka Nagao 1 , Tairo Kashihara 1 , Kana Takahashi 1 , Koji Inaba 1 , Kae Okuma 1 , Masayuki Matsuo 2 , Hiroshi Igaki 1 1 Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. 2 Radiology, Gifu University School of Medicine, Gifu, Japan Purpose/Objective: In postoperative radiotherapy (PORT) for high-risk hypopharyngeal cancer, bilateral neck irradiation (BNI) with primary tumor-bed coverage is standard. At our institution, unilateral neck irradiation (UNI) is selected when the contralateral neck lacks extranodal extension (ENE) and multiple nodal metastases. Tumor-bed omission (No-TB) is adopted for negative margins. We retrospectively evaluated our outcomes. Material/Methods: Among 138 consecutive patients who received PORT between January 2014 and December 2024, 77 who underwent total pharyngolaryngectomy with bilateral neck dissection were analyzed. The cumulative incidence of regional recurrence (CIRR) was evaluated using the Fine–Gray model with death as a competing event. Local control (LC), overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan–Meier and compared with log-rank tests. All treatments were delivered with VMAT, with 60–66 Gy to high-risk regions and 46–54 Gy to elective regions. Results: The cohort included 69 men with a median age of 68 years (49–81). Subsites were pyriform sinus in 60 patients, posterior pharyngeal wall in 11, and postcricoid region in 6. Midline crossing was present in 58. Histology was squamous cell carcinoma in 74 and adenosquamous carcinoma in 3. Most patients had clinical stage IV disease. Pathology showed pT4 in 31, lymphovascular invasion in 68, and perineural invasion in 25. Radical neck dissection was performed in 46 patients. The median number of positive nodes was 4 (0–19). Bilateral or contralateral nodal metastasis was present in 38 patients. Nodes ≥ 3 cm were observed in 26. Indications for PORT included positive/close
Conclusion: UNI may be an option when the contralateral neck lacks ENE and multiple nodal disease, and No-TB may be considered for negative margins. In this cohort, these strategies did not compromise regional or local control or survival. Prospective validation is warranted. Keywords: Hypopharyngeal Cancer, Postoperative radiotherapy
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