S587
Clinical – Head & neck
ESTRO 2026
Of 90 screened patients, 60 were randomized. Baseline mean anxiety score was 61. For the primary outcome, the effect size was d = 0.3 for music therapy—corresponding to a small-to-moderate effect (between 0.2 and 0.5)and approximately d = 0 for hypnosis, indicating no measurable effect on anxiety. Mixed-model analysis showed a significant overall decrease in anxiety over time across all groups (p<0.001) but no significant group effect (p=0.06). No significant temporal dissociation was observed in the hypnosis arm. Conclusion: This randomized study did not demonstrate superiority of hypnosis over anxiolytic premedication or music therapy in anxiety management during HN EBRT. However, all three approaches were effective in maintaining treatment continuity and reducing anxiety over time. Music therapy showed promising results and represents a simple, non-invasive alternative that warrants confirmation in larger multicentric studies. Keywords: hypnosis, claustrophobia, contention mask Digital Poster 2142 Comparison of the 8 th and 9 th edition TNM staging systems in HPV-associated oropharyngeal carcinoma: a stepwise reclassification Miriam Tomaciello 1 , Chiara Gaudino 2 , Elisa Vitti 1 , Maura Anna Lanzilao 1 , Alessia Delle Donne 1 , Carolina Gentili 1 , Cira Di Gioia 1 , Giuseppe Minniti 1 , Francesca De Felice 1 1 Radiological,Oncological and Pathological Sciences, Sapienza, Rome, Italy. 2 Neuroradiology, Sapienza, Rome, Italy Purpose/Objective: Previous TNM staging for human papillomavirus (HPV)-associated oropharyngeal carcinoma (OPC) did not account for imaging-detected extranodal extension (iENE), leading to heterogeneous clinical nodal (cN) classification [1]. The recently released 9th edition TNM incorporates iENE to enhance prognostic accuracy [2]. This study aimed to evaluate the impact of iENE-based reclassification on disease-free survival (DFS) in patients with HPV-associated OPC. Material/Methods: Patients with HPV-associated OPC and positive lymph nodes at diagnosis, treated with curative-intent chemoradiotherapy (CRT), were retrospectively reviewed[3]. Pre-treatment MRIs were assessed by a head and neck radiologist for iENE. All cases were (re)staged according to the 8th and 9th edition TNM systems. Demographics, tumor characteristics and treatment response data were collected.DFS was estimated using the Kaplan-Meier method, and survival curves were compared by the log-rank test.
Poster Discussion 2110 Comparison of Hypnosis, Music Therapy and Anxiolytic Premedication for Anxiety Management During Head and Neck Radiotherapy: The HYMACO Study Sophie Renard 1 , Rémi Etienne 2 , Julia Salleron 3 , Maria Jolnerovski 4 , Mathilde Cuenin 4 , Juliette Jacques 4 , Marie Bruand 4 , Nicolas Martz 4 , William Gehin 4 , Sébastien Cambier 4 , Jean-Christophe Faivre 5 1 radiotherapy, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France. 2 SISSPO, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France. 3 Biostatistiques, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France. 4 radiotherapy, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France. 5 radiotherapy, Institut de Cancérologie de Lorraine, Vandoeuèvre-Lès-Nancy, France Purpose/Objective: External Beam Radiotherapy (EBRT) for head and neck (HN) tumors requires immobilization with a thermoformed mask to ensure precision. However, this mask often induces a feeling of confinement, leading to anxiety or even panic attacks in susceptible patients. Anxiety can cause treatment delays or interruptions, which may impact tumor control. The HYMACO study aimed to compare the efficacy of hypnosis, music therapy, and anxiolytic premedication in reducing anxiety during CT simulation and EBRT in anxious or claustrophobic patients. Material/Methods: This monocentric, randomized study enrolled adult patients undergoing EBRT for HN tumors between December 2020 and December 2025. Patients reporting stress related to the immobilization mask and presenting a State-Trait Anxiety Inventory form Y- A (STAI Y-A) score ≥ 46 were randomized into three arms: (1) anxiolytic premedication, (2) music therapy, or (3) self-hypnosis. In the hypnosis arm, patients received preparatory training in anchoring techniques by certified staff. Music therapy consisted of personalized instrumental music selected by a music therapist. The primary endpoint was the level of anxiety, assessed by the highest score obtained on the STAI Y-A across the three assessment points: during CT simulation, and at the first and fifth radiotherapy sessions. The effect size, Cohen’s d, was used to quantify the differences in anxiety scores between each intervention (music therapy vs. anxiolytic premedication, hypnosis vs. anxiolytic premedication). One of the secondary endpoints, perceived versus actual session duration, was used as a marker of temporal dissociation and an indicator of hypnosis effectiveness. Results:
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