S662
Clinical – Head & neck
ESTRO 2026
Conclusion: This prospective study shows a clear acute decline in social functioning, followed by progressive recovery and partial reintegration after NPC treatment.Despite residual social limitations, most patients reported meaningful improvement several years after therapy. In an LMIC context, these findings indicate that IMRT- based protocols can preserve social functioning outcomes comparable to high-income settings, provided that psychosocial and nutritional support are integrated early in survivorship care. Keywords: Nasopharyngeal carcinoma, Social functioning Digital Poster 4520 Carboplatin versus cisplatin as concurrent agents with radiotherapy in head and neck cancer: comparative locoregional outcomes Hannah L Bromley 1,2 , Lip Wai Lee 1 , Kate Garcez 1 , Christopher Hughes 1 , YiWay Lim 1 , David Thomson 1,2 , James Price 1 1 Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. 2 Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom Purpose/Objective: Cisplatin is the standard concurrent agent for chemoradiotherapy (CRT) in head and neck squamous cell carcinoma. In the UK, carboplatin is often substituted when cisplatin is contraindicated, but comparative outcome data are limited. We compared locoregional failure (LRF) across treatment regimens. Material/Methods: Consecutive patients with locally advanced (T3/4 and or node-positive) p16 positive oropharyngeal squamous cell carcinoma who received radiotherapy with concurrent cisplatin, carboplatin, or radiotherapy alone from January 2011-December 2022. The primary endpoint was 2-year LRF, with distant metastasis and non-cancer death treated as competing events. Cumulative incidence functions were estimated, and Fine–Gray models were fitted, adjusted for age, ECOG performance status, ACE-27 comorbidity score, smoking category, and AJCC-8 T and N stage. Progression-free survival (PFS) was assessed using Kaplan–Meier and multivariable Cox models with the same covariates. Results: A total of 640 patients were included (cisplatin 376, carboplatin 80, radiotherapy alone 184) (Table). Carboplatin recipients were older (median 61 vs 57 years for cisplatin, 72 for radiotherapy alone; p<0.001), had poorer performance status (ECOG 0: 59% vs 84%; ECOG ≥ 2: 3.8% vs 0.3%), and greater comorbidity (ACE
≥ 2: 10% vs 6%). T-stage also varied, with a higher proportion of advanced (T3–4) tumours among carboplatin (59%) and radiotherapy-alone (55%) cohorts compared with cisplatin (45%) (p=0.007). The most common reasons for cisplatin ineligibility were renal impairment (16 patients), hearing impairment (14), tinnitus (12), neuropathy (10), cardiac history (7), comorbidity burden (9), and institutional COVID-19 policy (12). Unadjusted 2-year LRF rates were 16% for carboplatin and 10% for cisplatin and radiotherapy alone (Figure). In adjusted Fine–Gray analysis, carboplatin showed a trend toward higher LRF versus cisplatin (sub-distribution HR 1.61, 95% CI 0.92–2.80; p=0.09), while radiotherapy alone showed no clear difference (1.16, 0.58–2.29; p=0.68). For PFS, carboplatin showed a non-significant trend toward worse outcomes compared with cisplatin (HR 1.41, 95% CI 0.88–2.27; p=0.20). Independent predictors of shorter PFS included higher ECOG (p=0.04), ACE (p=0.008), T and N stage (both p<0.001).
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