S663
Clinical – Head & neck
ESTRO 2026
(60–74 Gy(RBE)) in 2.0 Gy(RBE) per fraction. Eleven patients underwent bilateral neck irradiation (BNI), either with a simultaneous or sequential boost; four of whom received concurrent cisplatin-based chemotherapy. Results: Acute toxicity analysis included mucositis, dysphagia, xerostomia and weight loss. Toxicities are reported as the maximum observed grade during proton therapy compared to baseline, and graded according to CTCAE v5.0.Most mucositis cases were mild, with 73%(11) G1 and 13%(2) G2. Two patients (13%) developed G3 mucositis; both received BNI, one also chemotherapy. Sixty percent of patients didn’t experience dysphagia, while G1 and G2 dysphagia occurred in 4 and 2 patients, respectively, all during BNI. Xerostomia was absent in 73% of patients; one developed G2 xerostomia.Median weight loss was 3.24% (0–7.9); 66.7% of patients showed <5% loss and 33.3% showed G1 loss (5–10% from baseline), these latter patients treated with BNI. A preliminary comparison between bilateral PAT (15)- and MFO (32)-treated patients with similar targets, stratified by concurrent chemotherapy, is shown in Fig. 1a–b and Fig. 2a–b, focusing on dysphagia and mucositis. G2 weight loss was only observed in only one patient treated with MFO and concurrent chemotherapy.No disease progression was observed among PAT-treated patients with HNC during the (short) follow-up period.
Conclusion: Carboplatin-based CRT was associated with numerically higher LRF compared with cisplatin, although this did not reach statistical significance and may be affected by differences in patient characteristics. Cisplatin should remain the preferred agent when tolerable, and alternative strategies for cisplatin-ineligible patients merit further prospective evaluation. Keywords: chemoradiotherapy, oropharynx, recurrence Digital Poster 4565 First-year clinical reports of static proton arc therapy for head and neck tumors Sara Saufi 1 , Marco Cianchetti 2 , Francesco Fracchiolla 3,4 , Irene Giacomelli 2 , Benedetta Siniscalchi 2 , Stefano Lorentini 3 , Frank Lohr 2 1 School of Radiation Oncology, University Milano- Bicocca, Monza, Italy. 2 Proton Therapy Department, Trento Hospital Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy. 3 UO Fisica Sanitaria, APSS Trento, Trento, Italy. 4 Faculty of Medicine, University of Bern, Bern, Switzerland Purpose/Objective: To report the initial clinical experience with static proton arc therapy (PAT) during the first year of clinical use. Material/Methods: After PAT implementation, 34 patients were treated in a fully CE-certified environment, representing the largest PAT cohort worldwide. Sixty-five percent of them had head and neck cancers (HNC), 23% skull base tumors, 6% brain or thoracic lesions; 6 patients of pediatric age.We report toxicity and preliminary oncological response in 15 radiation-naive adult patients with HNC. Median follow-up is 3.9 months (1.1–11.5).The disease stage was cT3–T4N0/N+ in 4 patients, pT3–T4N0/N+ in 8, pT2N0 in 2, and cT2N0 in 1 patient. The median delivered dose was 66.0 Gy(RBE)
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