S606
Clinical – Head & neck
ESTRO 2026
Digital Poster Highlight 2848 The impact of national consensus statements on reduction of side effects in oropharynx radiotherapy Shona Boyle 1 , Stephanie Anderson 2 , Claire Paterson 2 , Derek Grose 2 , Carolynn Lamb 2 , Stefano Schipani 2 , Saurabh Vohra 2 , Christina Wilson 2 1 Internal Medicine, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom. 2 Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom Purpose/Objective: Publication of national consensus statements aimed to reduce unwarranted variation in practice and optimise radiotherapy target delineation in the UK [1]. Guidance included the use of unilateral radiotherapy for well- lateralised tonsil squamous cell carcinoma (tSCC) and the use of the 5+5 technique to create clinical target volumes (CTVs). The aim of this work was to evaluate the impact of these guidelines on practice, morbidity
patient and tumor related factors. Material/Methods:
Patients with stage I and II oral cavity cancers (OCCs) treated from 2020 to 2022 were included. Analyzed parameters included age, comorbidities, histology, largest tumor dimension, depth of invasion (DOI), closest margin, lymphovascular space invasion (LVSI), perineural invasion (PNI), whether the patient developed recurrence or not, date of recurrence, and date of last follow-up. Correlation between the parameters and recurrence was assessed and the progression-free survival (PFS), defined from the time of surgery until recurrence, was studied using the Kaplan-Meier method. Results:
and disease control. Material/Methods:
This was a retrospective cohort study in a regional cancer centre. Eligible patients had tSCC, T1-2, N0- 1,p16+ve (N0-2b, p16 -ve, AJCC 8th edition) treated with radical (chemo) radiotherapy [2]. Two time periods were evaluated - pre consensus statements (PreCS), February 2018 to January 2020 and post consensus statements (PostCS), February 2022 to January 2024. Patient and disease characteristics, treatment parameters, acute side effects and outcomes were compared. Statistical analysis was performed using Excel and R. Results: Ninety-eight patients were eligible, PreCS n=54, PostCS n=44. Patient characteristics are shown in table 1.
Eighty patients were included. The median age was 54 years. Eighty-six percent of the patients had moderately differentiated squamous cell carcinoma, while the rest had either verrucous carcinoma (n=7), or dysplasia with a microinvasive focus. The median tumor size was 2 cm and DOI was 5 mm. Recurrences were detected in 23 patients. A weak positive correlation was noted with age, tumor size, depth of invasion, margins ( ρ =0.2, 0.12, 0.23, 0.27 respectively, p<0.05), LVSI ( φ =0.24, p=0.16), and a moderate positive correlation was noted with PNI, albeit statistically not significant ( φ =0.5, p=0.61). Multivariate analysis revealed no significant association between the factors and recurrence rates. The median PFS survival of the patients was 54 months (95% CI 47 months to 58 months) (Figure 1). Conclusion: Observation following surgery remains a viable management strategy for stage I and II oral cavity cancers, offering acceptable survival outcomes with reduced risk of adjuvant treatment-related morbidity, and our outcomes align with the current practice. Close follow-up in these patients is key to ensure the continuation of the positive outcomes. Keywords: early stage oral cancers, observation, recurrence
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