Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_23_2554 - Intensity-modulated proton therapy reduces acute treatment-related toxicities for patients with nasopharyngeal cancer: A case-control propensity score match study with volumetric modulated arc therapy

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

Intensity-modulated proton therapy reduces acute treatment-related toxicities for patients with nasopharyngeal cancer: A case-control propensity score match study with volumetric modulated arc therapy
Y. C. Chou1, S. P. Hung2, C. E. Hsieh3, Y. Y. Wu1, and J. T. C. Chang2; 1Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, 2Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, 3Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

Purpose/Objective(s): To evaluate the differences in the treatment related toxicity and neutropenia rate between patients with nasopharyngeal cancer treated by IMPT and VMAT.

Materials/Methods: From December 2016 to December 2017, 27 patients receiving IMPT and 54 patients receiving VMAT for nasopharyngeal caner were propensity score-matched with 1:2 ratio. The propensity score were generated based on age, sex, T-stage, N-stage, EBV status and treatment modalities. The National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE 4.03) was used for toxicity evaluation. Chi-square test was used in the univariate analysis. Then multivariate logistic regression analysis was used in the multivariate analysis for binary toxicity endpoints.

Results: The median follow-up time was eight months. There were no imbalances between the two cohorts patients. During treatment, 6 IMPT-treated patients (22.2%) and 27 VMAT-treated patients (50%) were suffered from nasogastric tube insertion or weight loss over 8 % from baseline (OR=0.286, P=0.018). Two patients (7.4% ) in IMPT cohort and eight patients(14.8%) in VMAT cohort required NG-tube insertion. The mean duration of NG-tube placement was 2 and 6.4 weeks in the IMPT and VMAT patients respectively (P=0.318). Of the patients treating with concurrent chemoradiotherapy, there were significantly less neutropenia adverse events in IMPT group compared with VMAT group (OR=0.324, P=0.029). There were only one patient (4.2%) in IMPT group and seven patients (14.3%) in VMAT group not receiving cisplatin dose intensity over 200 mg/m2. After allowing potential confounders in multivariate analysis, IMPT treatment retained its independent association with NG-tube insertion or weight loss over 8% (P=0.049)and neutropenia adverse events (P=0.039).

Conclusion: IMPT is associated with reduced rates of NG-tube insertion or weight loss over 8% and neutropenia adverse events. The result may potentially increase treatment outcome for nasopharyngeal cancer patients treated with IMPT.
IMPT (N =27) VMAT (N=54) OR (95% CI) P value
NG tube during treatment, No. (%) 2 (7.4) 8 (14.8) 0.460 (0.091-2.334) 0.483
NG tube duration, mean (IQR), wks 6.4 (4.5-8.3) 2 (1-3) 0.318
Weight loss over 8%, No. (%) 5 (18.5) 22 (40.7) 0.331 (0.109-1.006) 0.051
Weight loss over 8% or NG tube during treatment, No. (%) 6 (22.2) 27 (50.0) 0.286 (0.100-0.819) 0.018
Total cisplatin dose < 200mg/m2 1 (4.2) 7 (14.3) 0.261 (0.030-2.253) 0.258
Neutropenia any grade 12 (50.0) 37 (75.5) 0.324(0.116-0.910) 0.029
Emergency Room Visit 3(11.1) 8 (14.8) 0.719 (0.174-2.961) 0.744

Author Disclosure: Y. Chou: None. C. Hsieh: None. Y. Wu: None.

Send Email for YUNG CHIH CHOU


Assets

MO_23_2554 - Intensity-modulated proton therapy reduces acute treatment-related toxicities for patients with nasopharyngeal cancer: A case-control propensity score match study with volumetric modulated arc therapy



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Intensity-modulated proton therapy reduces acute treatment-related toxicities for patients with nasopharyngeal cancer: A case-control propensity score match study with volumetric modulated arc therapy