ESTRO 2022

Session Item

Head and neck

Session Code: 6000

Session Type: Poster (digital)

Track: Clinical

First year survival data on COVID-19 outbreak during radiotherapy course in head and neck cancer

Anna Bandurska-Luque, Poland

Presentation Number: PO-1115

Abstract

Abstract Title:

First year survival data on COVID-19 outbreak during radiotherapy course in head and neck cancer

Authors:

Anna Bandurska-Luque¹, Róża Poźniak-Balicka², Tomasz Winiecki³, Tomasz Bajon⁴, Anna Adamska⁵, Małgorzata Żmijewska-Tomczak⁶, Piotr Milecki⁷, Joanna Kaźmierska⁸

¹Greater Poland Cancer Centre, Radiotherapy Department II, Poznań, Poland; ²Collegium Medicum of University of Zielona Góra, Department of Radiotherapy - University Hospital Zielona Góra, Zielona Góra, Poland; ³Greater Poland Cancer Centre, Radiotherapy Department II , Poznań, Poland; ⁴Greater Poland Cancer Centre, Radiotherapy Department II , Poznań, Poland; ⁵Greater Poland Cancer Centre, Radiotherapy Department I, Poznań, Poland; ⁶Greater Poland Cancer Centre, Radiotherapy Department I, Poznań, Poland; ⁷Poznan University of Medical Sciences, Department of Electroradiology, Radiotherapy Department I, Greater Poland Cancer Centre, Poznań, Poland; ⁸Poznan University of Medical Sciences, Department of Electroradiology, Radiotherapy Department II, Greater Poland Cancer Centre, Poznań, Poland

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Purpose or Objective

To evaluate the first year survival data of patients with head and neck cancer (HNC), whose radiation (RT) or chemo-radiation (CRT) course was affected by second wave of COVID-19 pandemic.

Material and Methods

We have performed a retrospective review and identified patients with confirmed SARS-CoV-2 infection or quarantine during RT/CRT of HNC who were treated in 3 radiotherapy departments form September 2020 till January 2021. The quarantine was imposed due to a close contact with COVID-19 positive person e.g. after hospitalisation in the same patient’s room. None of the patients was vaccinated prior to the treatment because the population-based vaccination program started in Poland in January 2021.

Log rank and univariate Cox test were used for two endpoints: overall survival (OS) and time to progression (TTP).

Results

36 patients (pts) with tumours in head and neck region were identified. Patients with sarcoma, paraganglioma, thyroid cancer and palliative RT were excluded (n=6). In total a cohort of 30 patients including squamous cell carcinoma (n=27), adenocarcinoma (n=2) and undifferentiated nasopharyngeal carcinoma (n=1) was farther evaluated. 50% (n=15) patients were treated with primary RT and 50% with adjuvant RT. Additionally, nine patients were treated with induction and/or concomitant chemotherapy. The median overall survival was 10.7 month (Range: 1-13.5). Three patients progressed (n=2 loco-regional, n=1 distant metastases), 11 patients died. 5 of them were categorised as COVID-19 related death, n=6 died in median 7.6 month after beginning of the treatment. 23 patients (77%) had SARS-CoV-2 infection confirmed and in the case of 7 patients RT was interrupted due to imposed quarantine. The median overall treatment time yield 56 days (9-106). 12 pts discontinue RT due to death (5 pts), deterioration of performance status (2 pts) and patients decision (7 pts, they received in median 85 % of prescribed radiation dose).

We did not observe a significant difference neither in log-rank test results for OS and TTP between COVID-19 and quarantine group (p=0.605 and p=0.135 respectively) nor on Cox univariate analysis (p=0,589). In subgroup of COVID-19 positive group there was a significant correlation between OS and duration of treatment interruption (p=0.047). The age, hypertension, cardiac diseases, chemotherapy or radiation dose received before treatment interruption did not correlate with OS.

Conclusion

In our cohort of patients COVID-19 infection did not worsen the survival probability in comparison to patients with quarantine, however the death ratio at median follow-up of 10.7 month yield 37%, which is high for curative treatment setting in head and neck cancer patients. More than half of death cases were COVID-19 related. Farther observation and evaluation of larger cohorts of patients, especially in vaccinated population is planned.