ESTRO 2022

Session Item

Head and neck

Session Code: 6000

Session Type: Poster (digital)

Track: Clinical

TOXICITY PROFILE OF 100 OROPHARYNGEAL CANCER PATIENTS TREATED WITH MODERN APPROACHES

Daniela Alterio, Italy

Presentation Number: PO-1088

Abstract

Abstract Title:

TOXICITY PROFILE OF 100 OROPHARYNGEAL CANCER PATIENTS TREATED WITH MODERN APPROACHES

Authors:

Daniela Alrerio¹, Giulia Corrao², Stefano Zorzi³, Giovanni Agostini⁴, Giulia Marvaso², Stefania Volpe², Luca Bergamaschi², Cristiana Pedone², Jessica Franzetti², Cecilia Bonfiglio², Anna Maria Camarda², Marta Tagliabue⁵, Maria Cossu Rocca⁶, Mohssen Ansarin³, Barbara Alicja Jereczek-Fossa²

¹IEO, European Institute of Oncology IRCCS, Division of Radiation Oncology, Milan, Italy; ²IEO, European Institute of Oncology IRCCS; University of Milan, Division of Radiation Oncology; Department of Oncology and Hematoncology, Milan, Italy; ³IEO, European Institute of Oncology IRCCS, Division of Otolaryngology and Head and Neck Surgery, Milan, Italy; ⁴University of Perugia, Section of Otolaryngology-Head and Neck Surgery, Milan, Italy; ⁵IEO, European Institute of Oncology IRCCS; University of Sassari, Division of Otolaryngology and Head and Neck Surgery; Department of Biomedical Sciences, Milan, Italy; ⁶IEO, European Institute of Oncology IRCCS, Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Treatment, Milan, Italy

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Purpose or Objective

Locally advanced oropharyngeal cancers (LAOPCs) can be treated with both non-surgical (chemoradiation) and surgical approaches. Whether the use of modern techniques (Intensity Modulated Radiotherapy -IMRT- and Transoral Robotic Surgery - TORS) could impact the toxicity profile of these two strategies has not been well established yet. Aim of the present study was to compare acute and long-term treatment-related side effects of two cohorts of patients (pts) with LAOPC treated with curative IMRT or TORS followed by postoperative IMRT.

Material and Methods

We retrospectively reviewed pts treated at our Institute from 2015 to 2020 for LAOPC. Inclusion criteria were: 1) locally advanced stages (III and IV according to AJCC 7^th Ed) 2) treated with IMRT (+/- chemotherapy - CT) or TORS followed by postoperative radiotherapy (PORT). Exclusion criteria were: 1) recurrent tumors 2) previous treatments on the head and neck region 4) 3D conformal radiotherapy technique 3) palliative treatments. Acute (at the end of the IMRT course) and early-late (at one year from the end of IMRT course) toxicities were reported according to Common Terminology Criteria Adverse Events (CTCAE v.3.04). Enteral nutrition, tracheostomia and oesophageal stricture occurred at any time during the follow-up period were also reported.

Results

A total of 100 pts matched inclusion criteria. Median age was 61 years (range 43-84) and 75% were male. Seventy-two (72%) pts underwent IMRT (90% concurrent CT) while 28 (28%) pts have been treated with TORS followed by PORT IMRT (61% concurrent CT). Tumor and patient characteristics have been reported in Table 1. After a median follow up of 24 months (range 1.4-74.4 months), all pts were alive and 86% and 87% resulted without disease in IMRT and TORS group, respectively. Locoregional recurrences occurred in 11% and 12% of pts treated with IMRT and TORS, respectively. Acute and early-late toxicity profile have been reported in Table 2. Eight (12%) and 4 (4%) pts required enteral nutrition during the radiation course in the IMRT and TORS group, respectively. Twenty one (30%) and two (7%) pts lost more than 10% (G3 toxicity) of their baseline value in the IMRT and TORS cohort, respectively. Tracheostomy, enteral nutrition and oesophageal stricture occurred at any time during the follow up period in 6%, 3%, 0% and 1%, 3%, 0% pts treated with IMRT and TORS, respectively.

Conclusion

Pts with LAOPCs treated with modern techniques experienced a favorable toxicity profile regardless the treatment approach. A higher proportion of G3 weight loss was found in the curative IMRT cohort compared to the TORS cohort. This finding could probably due to the presence of macroscopic disease which could cause mechanic dysphagia, the higher rate of advanced primary tumor stage and concurrent chemotherapy in this group of pts compared to those treated with TORS.