S607
Clinical – Head & neck
ESTRO 2026
Conclusion: National consensus statements have changed practice in our regional cancer centre. Despite a higher proportion of T2 and node-positive patients, we observed an increase in unilateral radiotherapy PostCS. This increased use of unilateral treatment included 72% of patients with multiple ipsilateral lymph nodes, an area that despite low incidences of CNR in reported meta-analysis studies continues to be controversial [3]. Due to a reduction from GTV to CTVHR margins, an associated reduction in CTVHR volume was identified. Reduced doses to organs of interest were also observed, leading to a significant decrease in the rates of severe dysphagia, mucositis and NG feeding in the PostCS cohort. Crucially, no patient had associated-isolated CNR. References: 1. Royal College of Radiologists. Head and neck RCR consensus statements, Feb 2022. 2. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017 Mar;67(2):93-99. 3. Razavian NB, D'Agostino RB Jr, Steber CR, Helis CA, Hughes RT. Association of Unilateral Radiotherapy With Contralateral Lymph Node Failure Among Patients With Squamous Cell Carcinoma of the Tonsil: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023 Feb 1;6(2). Keywords: oropharynx, radiotherapy, side-effects Pet-guided robotic stereotactic radiosurgery for head and neck paragangliomas: first planning insights Khadija Al-Madailwi 1 , Larissa Kilian 1 , Diana Sladek 1 , Chiara Eitner 1 , Julia Bauer 1 , Daniel Zips 1 , Carolin Senger 1 , Gueliz Acker 2,1 1 Department of Radiation Oncology, Charité – Universitaetsmedizin Berlin, Berlin, Germany. 2 Department of Neurosurgery, Charité – Universitaetsmedizin Berlin, Berlin, Germany Purpose/Objective: In stereotactic radiosurgery (SRS) planning, accurate delineation of tumor margins and adjacent organs at risk is essential for optimizing target coverage and minimizing toxicity. However, interpreting conventional neuroimaging modalities such as CT and MRI can be challenging, particularly in head and neck paragangliomas, where tumors often exhibit irregular growth patterns and close proximity to critical Digital Poster 2886 neurovascular structures, making it difficult to define precise anatomical borders. The aim of this study was
PreCS 35.2% patients received unilateral radiotherapy versus 79.5% PostCS (p <0.01). PreCS 11.1% patients with ≥ 2 lymph nodes had unilateral radiotherapy vs 72.0% PostCS. Margin from GTVp to CTV high-risk (CTVHR) decreased by a median of 10mm, and volume CTVHR decreased by a median of 83.5cc in the PostCS cohort. Post CS, the mean dose delivered to larynx and contralateral parotid was significantly reduced by 920.6cGy and 1003.4cGy (p<0.01), respectively (Table 2). The rate of severe (grade 3-4) dysphagia and mucositis decreased PostCS by 23% (p=0.03) and 27.3% (p<0.01), respectively. Furthermore, the rate of NG use decreased by 27.3% PostCS.
Median follow up for PreCS patients was 73 months and 31.5 months PostCS. No patients in either group had associated isolated contralateral neck recurrence (CNR).
Made with FlippingBook - Share PDF online