S661
Clinical – Head & neck
ESTRO 2026
Digital Poster Highlight 4496
Prospective, randomized, two-arm study including LA- HNSCC (oropharynx, hypopharynx, larynx) eligible for radical chemoradiation. Patients were randomized 1:1 to:SIB-IMRT: 70 Gy/35# (HR-PTV), 60 Gy/35# (IR-PTV), 54 Gy/35# (LR-PTV).SEQ-IMRT: 54 Gy/27# (LR+IR+HR) → 6 Gy/3# (IR+HR) → 10 Gy/5# (HR).Both arms received weekly Cisplatin (40 mg/m ² ). Acute toxicities were recorded weekly as per CTCAEv5.0. Dysphagia- aspiration risk structures (DARS: superior/middle/inferior pharyngeal constrictors) were contoured; mean doses were compared. Objective response at 6 months was assessed as per RECIST v1.1. Statistical analysis was done using SPSSv31. Results: Interim randomized cohort N=120 (60/arm).Objective response at 6 months: Complete response 83.3% in both arms; partial response 16.7% SIB vs 13.3% SEQ (p=0.060); progressive disease 0 vs 1 (4.2%, p=0.500).Acute toxicities: • Dermatitis: SIB Grade 1/2/3 = 58.3%/25.0%/16.7% vs SEQ 41.7%/54.2%/4.2% (p=0.700 overall). • Mucositis: Lower Grade 3 with SIB than SEQ. • Dysphagia: Higher Grade 2 with SIB than SEQ. • Xerostomia & anaemia: Comparable across arms. • Bone marrow hypocellularity: Grade 1/2 = 75%/25% (SIB) vs 58.3%/41.6% (SEQ) (p=0.644).DARS doses: Mean doses to superior and middle pharyngeal constrictors tended to be higher with SIB (e.g., SPCm 48.86 Gy vs 43.55 Gy, p=0.082; MPCm 46.04 Gy vs 38.44 Gy, p=0.057), aligning with observed dysphagia patterns. Conclusion: Both techniques achieved an equivalent 6-month response (CR 83.3% each). SIB-IMRT showed a lower incidence of Grade 3 mucositis and higher Grade 2 dysphagia, with dermatitis and xerostomia comparable to those with SEQ-IMRT. DARS dose trends favoured SEQ for pharyngeal constrictors. References: Grover, A., Soni, T. P., Patni, N., Singh, D. K., Jakhotia, N., Gupta, A. K., Sharma,L. M., Sharma, S., & Gothwal, R. S. (2021). A randomized prospective studycomparing acute toxicity, compliance, and objective response rate betweensimultaneous integrated boost and sequential intensity-modulated radiotherapy forlocally advanced head and neck cancer. Radiation Oncology Journal, 39(1), 15– 23.doi:10.3857/roj.2020.01018 Keywords: SIB-IMRT, Sequential IMRT, DARS structures
Prospective analysis of social functioning and reintegration after chemoradiotherapy for nasopharyngeal carcinoma in an LMIC Setting Nejla Fourati, Malek Dabbous, Yosra Kochlef, Wafa Mnejja, Zied Fessi, Wicem Siala, Jamel Daoud Radiotherapy Department Habib Bourguiba Hospital, Faculty of Medicine University of Sfax, Sfax, Tunisia Purpose/Objective: Beyond tumor control, social functioning and reintegration are essential dimensions of patient recovery—both during treatment and in the long-term survivorship phase—after chemoradiotherapy for nasopharyngeal carcinoma (NPC).However, data describing these aspects remain scarce, particularly in low- and middle-income countries (LMICs).This study aimed to evaluate the trajectory of social functioning and its related domains, using the validated Arabic versions of the EORTCQLQ-C30 and EORTCQLQ-HN35 questionnaires. Material/Methods: An initial cohort of 45 NPC patients was prospectively followed. After a median follow-up of 83 months [68– 93], 21 patients in continuous remission were included in this long-term quality-of-life (QoL) analysis.The median age was 45 years [23–68], with a sex ratio of 2.5.All patients received intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy, and 95% underwent neoadjuvant chemotherapy.QoL was evaluated at baseline (B), week 3 (W3), week 6 (W6), 1–6 months (M1–M6), and long-term (L) using the EORTC QLQ-C30 (Social Functioning (SF): higher scores indicate better functioning) and the EORTC QLQ-HN35 (Social Eating (HNSO) and Social Contact (HNSC): higher scores indicate worse symptoms). Scores were linearly transformed to a 0–100 scale.As data were non-normal, Wilcoxon paired tests and a Friedman test were used.Patients were categorized as improved, stable, or worsened between B, W6, M6, and L. Results: The Friedman test revealed a significant time effect for HNSO (p=0.002), while changes in SF (p=0.09) and HNSC (p=0.06) did not reach statistical significance.SF declined from 70.6±36.6 (B) to 50.0±34.5 (W6, p=0.003), followed by partial recovery at M6: 62.2±32.7 and L: 65.9±32.1 (p = 0.59 vs B). This trajectory suggested a sustained trend toward social reintegration.HNSO increased from 2.8±5.1 (B) to 60.0±29.4 (W6, p=0.001), improving to 13.6±16.4 (M6) and 11.1±19.6 (L, p=0.002 vs W6).HNSC rose from 1.1±3.7 (B) to 40.4±20.7 (W6, p=0.002), then decreased to 11.8±12.8 (M6) and 9.1±10.9 (L, p=0.009 vs W6).At long-term follow-up (L), 69% of patients demonstrated improved or stable social functioning compared with W6.
Made with FlippingBook - Share PDF online