S630
Clinical – Head & neck
ESTRO 2026
Purpose/Objective: Cancer of the post-cricoid (CPC) region represents a rare subtype of hypopharyngeal carcinoma. Data on outcomes following treatment with modern radiotherapy (RT) techniques are limited. This study presents institutional outcomes of CPC treated with VMAT-based chemo-RT. Material/Methods: A retrospective analysis was conducted on 65 consecutive patients with histologically confirmed CPC who received curative-intent VMAT between January 2020 and December 2023. All underwent standardized staging, multidisciplinary tumour board review, and image-guided VMAT using simultaneous integrated boost (SIB) protocols to doses of 66–70 Gy. Outcomes assessed included acute and late toxicities, loco- regional recurrence-free survival (LRRFS), cause- specific survival (CSS), and overall survival (OS). Results: Median age of the cohort was 50 years, with 67.7% being female. Loco-regionally advanced disease was present in 84.7%. Dose of 66 Gy in 30 fractions was prescribed to HR-PTV in 90.8%. 91% received concurrent chemotherapy. Median overall treatment duration was 43 days.Acute RTOG grade 3 toxicities included dermatitis (3.1%), mucositis (1.5%), and dysphagia (7.7%). No grade ≥ 4 acute toxicities were reported. Median weight loss during treatment was 3 kg.Response evaluation was performed in 63 patients (96.9%). Two patients (3.1%) died before assessment— one due to aspiration pneumonia and one from an unknown cause. A complete clinico-radiological response was achieved in 80.9%, residual disease was observed in 10 (local: 7, loco-regional: 1, regional: 2). The predominant pattern of failure was local (19%), followed by regional and combined loco-regional failures (6.3% each). Median time to recurrence was 12 months. All loco-regional failures occurred within the high-dose treatment volumes.At a median follow-up of 34 months, the two-year LRRFS, CSS, and OS rates were 63.5%, 57.9%, and 47.7%, respectively. The median OS for the entire cohort was 33 months, and only 8 months among patients who did not achieve CR. Of the 31 patients (47.7%) who died, 23 (74.2%) succumbed to disease progression, while 8 (25.8%) died from other causes, including pleuropulmonary fistula (n=1), sepsis (n=1), aspiration pneumonia (n=2), and unknown causes (n=4).Late toxicities included oesophageal strictures in 50.8% of patients, with 37% requiring dilatation, and feeding tube dependence persisting in 16% at one year. Multivariate analysis identified low baseline haemoglobin, larger gross tumour volume, and omission of concurrent chemotherapy as predictors of poorer outcomes. Conclusion: VMAT-based chemo-RT offers promising disease control for CPC with manageable toxicity. However,
oesophageal strictures requiring intervention were common. These findings underscore the critical role of precision radiotherapy and multidisciplinary care in managing CPC. References: 1. Vulcu Cordunianu AG, Ganea G, Alexandru Cordunianu M, Cochior D, Alec Moldovan C, Adam R, et al. Hypopharyngeal cancer trends in a high-incidence region: A retrospective tertiary single center study. World J Clin Cases [Internet]. 2023 Aug 26 [cited 2025 Apr 8];11(24):5666. 2. Laskar SG, Sinha S, Singh M, Mummudi N, Mittal R, Gavarraju A, et al. Post-cricoid and Upper Oesophagus Cancers Treated with Organ Preservation Using Intensity-modulated Image-guided Radiotherapy: a Phase II Prospective Study of Outcomes, Toxicity and Quality of Life. Clin Oncol (R Coll Radiol) [Internet]. 2022 Apr 1 [cited 2025 Apr 10];34(4):220–9. Keywords: Post cricoid cancer, hypopharyngeal cancer, VMAT Local control, side effects, and psychosocial distress after irradiation of squamous cell carcinomas of the nasal vestibule Laura Oebel 1 , Christian Grad 1 , Justus Kaufmann 1 , Karoline O´ Brien 2 , Liv Weimer 1 , Anna Schunn 1 , Nina Gercek 1 , Stephanie Göller 1 , Heinz Schmidberger 1 1 Radiation Oncology, University Medical Center Mainz, Mainz, Germany. 2 Head and Neck Surgery, University Medical Center Mainz, Mainz, Germany Purpose/Objective: Squamous cell carcinomas of the nasal vestibule represent less than 1% of all malignancies of the head and neck region. Due to the rarity of this entity, there is no uniform standard of therapy. Therapeutic Digital Poster 3707 options are surgical resection and, alternatively, for T1 and T2 tumors, definitive external radiation therapy or brachytherapy. When risk factors such as narrow resection margins or regional lymph node metastases are present, surgery is often followed by adjuvant radiotherapy. Surgical treatment usually implies a considerable intervention in the physical appearance of the patient. Material/Methods: A retrospective analysis of 36 patients with the initial diagnosis of a nasal vestibule carcinoma between 05/2010 and 03/2025 concerning local and locoregional control, acute and late toxicities, as well as psychosocial stress after completion of therapy was performed. 32 patients received tumor resection with adjuvant radiotherapy, and four patients received definitive radiotherapy. The median follow-up period was 61 months. Acute side effects were classified
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