S613
Clinical – Head & neck
ESTRO 2026
Digital Poster 3102 SIB PLANNING IN CARBON ION RADIOTHERAPY FOR HEAD AND NECK ADENOID CYSTIC CARCINOMA: PRELIMINARY RESULTS OF PROSPECTIVE PHASE II TRIAL SIBACIRT. Sara Ronchi 1 , Silvia Molinelli 2 , Angelica Facoetti 3 , Russo Stefania 2 , Eleonora Rossi 2 , Barbara Vischioni 1 , Maria Bonora 1 , Rossana Ingargiola 1 , Anna Maria Camarda 1 , Mariangela Caputo 1 , Alexandra Charalampopoulou 3 , Sara Imparato 4 , Nadia Facchinetti 5 , Beatrice Amaglio 2 , Cesare Piazza 6,7 , Stefano La Rosa 8 , Giuseppe Mercante 9 , Ester Orlandi 1,10 1 Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 2 Medical Physics Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 3 Radiobiology Unit, Research and Development Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 4 Radiology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 5 Scientific Direction, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 6 ) Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy. 7 Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. 8 Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy. 9 Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Milan, Italy. 10 Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy Purpose/Objective: To report preliminary results of SIBACIRT prospective phase II trial. Aim of the study is to investigate whether a Simultaneous Integrated Boost (SIB) planning approach in Carbon Ion Radiotherapy (CIRT) for head and neck adenoid cystic carcinoma (HNACC) can significantly reduce toxicity without affecting Local Control, compared to the standard sequential planning strategy. Material/Methods: SIBACIRT is a monocentric, single arm prospective phase II clinical trial planning to enrol 42 patients with HNACC (unresectable or post-surgery) to be treated with CIRT with SIB approach. The primary endpoint is acute and subacute toxicity (within 180 days after the end of treatment), graded using CTCAE version 5.0. Secondary endpoints are: 1) local control assessed at least 12 months after starting of treatment; 2) development of multivariate predictive models, including clinical and dosimetric parameters, for different toxicity endpoints; 3) Quality of Life (QoL)
286 patients, 123 patients were <60, 101 were 60-70 and 62 were >70 years old. Median follow-up was 38 months (range 2-162 months), and those aged 70+ had worse performance status (PS), higher baseline comorbidities, and were less likely to receive concomitant chemotherapy (OR: 0.72, 95% CI: 0.63 – 0.81). OS and PFS were lower in 70+ group although no statistically significant difference was seen across age groups (Figure 1). On multivariable analysis, higher risk of death was associated with worse PS and comorbidities along with presence of lymphovascular and perineural invasion and extranodal extension, but not with age group. When looking at cause-specific deaths, despite similar proportions of head and neck cancer deaths across age groups, there was a trend towards higher incidence of non-cancer deaths in older age groups (Figure 2).
Conclusion: Performance status and comorbidities rather than older age per se independently predict overall survival following combined modality treatment for stage III/IV OCSCC, which may reflect increased probability of dying from causes other than cancer in older age groups. References: 1. Young T, et al. RT-HaND_C: A Multi-Source, Validated Real-world Head and Neck Cancer Dataset for Research, Clinical Oncology, Volume 47, 2025. https://doi.org/10.1016/j.clon.2025.103935.2. Zhou S, et al. The Age-Adjusted Charlson Comorbidity Index Predicts Prognosis in Elderly Cancer Patients. Cancer Manag Res. 2022 May 6;14:1683-1691. doi: 10.2147/CMAR.S361495. PMID: 35573259; PMCID: PMC9091471.3. Andersen P, et al. Competing risks in epidemiology: possibilities and pitfalls. International Journal of Epidemiology, Volume 41, Issue 3, June 2012, Pages 861–870. https://doi.org/10.1093/ije/dyr213. Keywords: oral cavity cancer, older patients, survival
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