S642
Clinical – Head & neck
ESTRO 2026
LPRHHT, NCIC, NRG oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines. Radiotherapy Oncology 126 (2018) 3-24. Keywords: Recurrence, GTV, CTV
recurrences were imaged in radiotherapy position using a dedicated MRI follow-up protocol. For this purpose the radiotherapy masks were stored and used for response evaluation and recurrence imaging. Recurrence MRIs were rigidly registered to the radiotherapy planning CT and MR images. Recurrence volumes were delineated and the center of mass (COM) was assumed to be the origin of the recurrence. In case of multiple recurrences, the recurrence most close to the primary gross tumor volume (GTV-P1) was analyzed. The distance from the COM to the various target volumes was calculated. The location of the recurrence was plotted to scale on a schematic patient (Figure 1). Results: In total 74 recurrences were analyzed in 460 patients. For oropharyngeal cancer, 36 (13%) recurrences were observed in 272 patients, for 22 patients recurrence imaging was performed. For laryngeal / hypopharyngeal cancer, 38 (20%) recurrences were observed in 188 patients, for 21 patients recurrence imaging was performed. Recurrences mainly (79%) originated in the gross target volume (GTV-P, GTV-N1) and high dose clinical target volumes (CTV-P1, i.e. the first 5 mm around the GTV-P according to Gregoire et al1). No recurrence was observed in the lower-dose CTV-P2 (i.e. the second 5 mm around the GTV-P). For cN+ patients, the recurrence was never in the elective volume. For cN0 patients, one recurrence was observed in the contralateral low dose elective volume, one in the ipsilateral low dose elective volume. No evidence of delineation or positioning errors was identified.
Digital Poster 3949 Health-Related Quality of Life Outcomes Following Radiation Therapy for Head and Neck Cancer: Experience from a Tertiary Care Center in South- Asia Mariam Hina, Bilal Mazhar Qureshi, Maham Khan, Laraib Khan, Tooba Ali, Maria Tariq, Nasir Ali, Asim Hafiz, Ahmed Nadeem Abbasi Radiation Oncology, Aga Khan University, Karachi, Pakistan
Purpose/Objective: Despite the improved survival achieved by
multimodality therapy, survivors of head and neck cancer (HNC) often have significant post-treatment morbidity. Health-related quality of life (HR-QoL) assessment provides important information on the functional and psychosocial consequences of radiation therapy (RT), especially in under-represented populations like South Asians. Material/Methods: All biopsy proven HNC patients receiving curative- intent RT (definitive or adjuvant), were enrolled in the study between August 2023 till December 2024. The EORTC QLQ-HN35 questionnaire was administered before starting RT and 12 ± 2 weeks post-RT at follow up visit. Mean ± SD were calculated for each domain. Paired t-test was used for analyzing pre- and post- treatment differences, while multivariate analysis (GLM-MANOVA) identified factors associated with HR- QoL outcomes. Results: We evaluated 56 patients whose mean age was 49 ± 13 years and 78.6% of whom were male. After treatment, there was significant worsening in the xerostomia (p = 0.004), pain (p = 0.011), and taste/smell (p = 0.018) domains, while improvements were noted in social contact (p = 0.048) and sexuality (p < 0.001). Tumor site, histological subtype, and marital status had the highest predictive value regarding HR-QoL outcomes. Patients with cancers of the oropharynx or hypopharynx experienced more posttreatment pain and problems with social eating. Conclusion: Within three months after curative-intent RT, patients with HNC showed deterioration in xerostomia, pain, and sensory loss but improved social contact and sexuality. Tumor site, histology, and marital status were the most important HR-QoL predictors, representing anatomical, biological, and psychosocial
Conclusion: Recurrences were mainly located in the GTV-P indicating that the patients received radiotherapy with accurate delineations and margins. The results suggest that the use of CTV-P2 might be reconsidered. References: 1 Gregoire V et al. Delineation of primary tumor clinical target volumes (CTV-P) in laryngeal, hypoharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT,
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