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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

3968 - Acute toxicity of concurrent radiochemotherapy for locally advanced head and neck cancer, a prospective study

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Elien Dewaele

Citation

Annals of Oncology (2018) 29 (suppl_8): viii603-viii640. 10.1093/annonc/mdy300

Authors

E. Dewaele1, P.J. van Dam2, B. De Laere2, C. Verschueren3, P.M.C. Specenier3

Author affiliations

  • 1 Oncology, Sint Trudo Ziekenhuis, 3800 - Sint-Truiden/BE
  • 2 Oncology, University of Antwerp, CORE, 2610 - Antwerp/BE
  • 3 Oncology, Antwerp University Hospital, 2650 - Edegem/BE
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Resources

Abstract 3968

Background

Concurrent chemoradiation (CCRT) is the standard treatment for patients with inoperable locoregionally advanced squamous cell carcinoma of the head and neck (HNSCC). CCRT can be associated with severe acute toxicity. Usually only the maximum grade of a limited selection of adverse events (AEs) is reported, without mentioning the evolution of toxicity over time. By the lack of the time factor, the global burden of toxicity experienced by the patient is not adequately reflected.

Methods

Adverse events (AEs) were prospectively scored according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 scoring system by 2 dedicated medical oncologists. AEs were evaluated at predefined time point from the start of CCRT up to 21 weeks after the start of CCRT. The cumulative toxicity load was measured by calculating the area under the curve (AUC) from AE score versus time functions. The AUC for each AE was obtained by multiplying the time and grade of each AE during that time. Mean AUC’s per patient category (i.e. HPV status, tobacco use, localisation of primary tumour and the use of ICT) were compared by Kruskal-Wallis testing.

Results

Forty patients (31 men), mean age 62.15 years, were included. The primary tumour site was located in 42.5% at the oropharynx and 45% were p16-positive. The AEs, with exception of xerostomia, typically developed in the second and third week of CCRT, with the intensity and frequency increasing during the treatment. Two weeks after ending CCRT (week 9), the side effects decreased. AEs were recorded in 85% (radiation dermatitis), 97% (orofacial pain), 89.7% (stomatitis), and 97.5% (anorexia) of patients. Significant different mean AUCs were seen for hoarseness (non-oropharynx group, p = 0.027), alopecia (the use of ICT, p = 0.00014), sensory PNP (the use of ICT, p = 0.00016), diarrhea (the use of ICT, p = 0.021), nausea (p16 positive, p = 0.047), and hoarseness (p16 negative, p = 0.015). For tobacco use no significant differences were seen.

Conclusions

This prospective trial recorded the maximum intensity and frequency of the different AEs, but also the evolution over time and the global AE load. More prospective trials with a larger number of patients are required to confirm the results.

Clinical trial identification

Legal entity responsible for the study

University Hospital Antwerp.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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