Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_37_2859 - Long term follow-up from a Phase I/II Trial Utilizing a Dose-Escalated Stereotactic Radiosurgery (SRS) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Long term follow-up from a Phase I/II Trial Utilizing a Dose-Escalated Stereotactic Radiosurgery (SRS) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer
P. Vempati1,2, A. N. Halthore3, S. Teckie4, J. Antone5, H. Zhang1, M. Marrero3, J. B. Cohen6, K. Beadle7, D. Frank3, D. Paul3, and M. Ghaly4; 1Department of Radiation Medicine at Northwell Health, Lake Success, NY, 2Department of Radiation Medicine at Northwell Health, Lake success, NY, 3Northwell Health, Lake Success, NY, 4Northwell Health, New Hyde Park, NY, 5Radiation Medicine, Northwell Health, Lake Success, NY, 6North Shore - Long Island Jewish Medical Center, Lake Success, NY, 7Hofstra Northwell School of Medicine, Lake Success, NY

Purpose/Objective(s): Patients with locally advanced oropharynx squamous cell carcinoma have poor outcomes with standard chemoradiation therapy. Here, we evaluated toxicity and oncologic outcomes of dose escalation using radiosurgical boost for patients with unfavorable oropharynx squamous cell carcinoma.

Materials/Methods: Thirty two patients with intermediate- or high-risk oropharynx squamous cell carcinoma were enrolled onto this prospective phase I trial. Each patient received concurrent cisplatin and fractionated radiotherapy totaling 60 Gy followed by single fraction radiosurgery boost of 8 Gy or 10 Gy to areas of gross tumor. Primary endpoint was treatment safety. Secondary endpoints were local, regional, and distant disease control.

Results: Eleven and 17 patients received a radiosurgery boost with either 8 Gy and 10 Gy, respectively. In terms of the side-effects, acutely 4 patients had tumor necrosis causing grade 3 dysphagia, of which 3 developed grade 4 pharyngeal hemorrhage requiring surgical intervention. At 46 months after treatment, 7%, 9%, and 15% had grade 2 dysgeusia, xerostomia, and dysphagia, respectively, and one patient remained feeding tube dependent. No grade 5 toxicities occurred secondary to treatment. Local, regional, and distant control at 46 months were 84.9%, 87.9% and 84.9%, respectively. The overall survival 84.8%.

Conclusion: This study is the first to report the feasibility of radiosurgery boost dose escalation in patients with unfavorable oropharynx squamous cell carcinoma. Longer follow-up, larger cohorts, and further refinement of boost methodology are needed prior to implementation in routine clinical practice.

Author Disclosure: P. Vempati: None. A.N. Halthore: Employee; U.S. Navy. S. Teckie: None. H. Zhang: None. D. Paul: None.

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MO_37_2859 - Long term follow-up from a Phase I/II Trial Utilizing a Dose-Escalated Stereotactic Radiosurgery (SRS) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer



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