ESTRO 38 Abstract book

S653 ESTRO 38

2-year LFS rate was 85.8% for all patients and 89.9% for T3 patients. Salvage laryngectomies were performed in 11 patients; of which 10 were performed within 2 years of CRT. Use of induction chemotherapy had no effect on LFS or OS. There was also no demonstrated difference in LFS rate between RT technique (IMRT vs. 3D-conformal), primary tumour localization (Supraglottic vs. Glottic) or T3 subgroup (fixed vs. mobile larynx or cartilage invasion vs. no cartilage invasion). Conclusion Our study illustrates high rates of OS, DFS and LFS. Functional preservation was highest in patients treated with IMRT. LEDFS rate was moderately low due to the inclusion of all-cause deaths, as per international consensus. The survival rates suggest that carefully selected patients with locally advanced laryngeal carcinoma can successfully be treated with larynx- preserving primary CRT without compromise on survival. EP-1180 Re-radiation in head and neck malignancies: experience from a tertiary care centre in eastern india J. Bhattacharya 1 , M. Mukherjee 1 , V. Kumar K 1 , R. Rajan 1 , T. Shahid 1 , S. Goswami 1 , L. Naha Biswas 1 , P. Chatterjee 1 , S. Saha 1 1 Apollo Gleneagles Hospital- Kolkata, Radiation Oncology- Cancer Block- 1st Floor, Kolkata, India Purpose or Objective Recurrent and second primary (RSP) of head-and-neck squamous cell carcinomas (HNSCC) arising within or close to previously irradiated areas are of significant clinical challenge. Salvage surgical resection is the standard of care, but reirradiation is often needed as an adjunct treatment and also needed when surgery is not feasible. The therapeutic ratio of reirradiation for RSP of HNSCC may be improved in the intensity modulated radiation therapy (IMRT) era. However, patient selection for reirradiation remains challenging. The aim of the study is to investigate outcomes after IMRT based reirradiation and to assess toxicity and median survival after re-irradiation in recurrent head and neck cancer patients treated at our institution since January 2013 till December 2017. Material and Methods All patients were treated after confirming prior radiation dose, treatment portal and treatment technique or by assuming patients got a full radical dose of prior radiation. Minimum gap of 6 months after prior radiation, PS ECOG 1-2, Age < 75 years, no prior grade 4 late toxicity were taken as the inclusion criteria. Results 43 patients were included of which 37 were male and 6 were female. Recurrent disease was local in 70% and second primary in 30%. Minimum and maximum radiation free interval was 6 months and 196 months respectively with a mean interval being 58 months. 44% were treated radically and 56% treated post-operatively. All the patients were treated with IMRT/VMAT with conventional fractionation. Target volumes in 30 patients included nodal volumes only and in 13 patients primary disease was the target. (Depending on the recurrence pattern). Mean dose to PTV was 58.6 Gy with a minimum dose of 36 Gy and maximum 66 Gy was prescribed according to the clinical scenario and disease free interval. 6 patients received concurrent chemotherapy. The rates of grade 3 and grade 4 acute toxicities were 18% and 4.2% respectively. Median survival was 33 months, with 61% of the 43 patients alive at the time of this analysis. Poor nutritional status, weight loss, speech and swallowing difficulty was the other toxicity seen almost in every patient. Conclusion Outcomes of our study reflect an efficient way of utilizing technology in combination with stringent patient selection criteria. IMRT technique must be applied with high priority to the limited target volume to reduce acute and late

Conclusion A higher interium SUVm of primary tumor was founded to be the prognostic indicator of oncological outcome. EP-1179 Primary concurrent chemoradiotherapy for locally advanced laryngeal squamous cell carcinoma D. Adjogatse 1 , F. De Felice 1,2 , Y. Suh 1 , J. Jeannon 3 , R. Oakley 3 , R. Simo 3 , M. Lei 1 , T. Guerrero Urbano 1 1 Guy's and St Thomas' NHS Foundation Trust, Department of Clinical Oncology, London, United Kingdom ; 2 Policlinico Umberto I “Sapienza” University of Rome, Department of Radiotherapy, Rome, Italy ; 3 Guy's and St Thomas' NHS Foundation Trust, Head and Neck Unit, London, United Kingdom Purpose or Objective Treating locally advanced laryngeal squamous cell carcinoma (SCC) with primary chemoradiotherapy (CRT) can preserve the larynx without compromising survival. However, whether this is associated with good functional outcomes remains up for debate. The aim of this study was to evaluate survival and functional outcomes in patients with locally advanced laryngeal SCC treated with primary CRT, with a focus on T3 disease. Material and Methods We retrospectively analysed data from all consecutive patients with stage III-IV (M0) disease treated with primary CRT in our centre between January 2007 and December 2016. Study endpoints were overall survival (OS), disease free survival (DFS), laryngectomy free survival (LFS), laryngo- oesophageal dysfunction free survival rate (LEDFS) and functional preservation rates (defined by freedom from tracheostomy or feeding tube at 2 years). Prognostic factors were assessed by univariate and multivariate analysis. Results 76 patients who underwent primary radical CRT were analysed. 25 patients received induction chemotherapy prior to CRT. 64 patients (89%) received concomitant platinum-based chemotherapy, and 8 (11%) concomitant Cetuximab. 74% of patients were treated with IMRT. All patients received elective nodal irradiation. The median follow-up was 42 months (range 3-109). Median OS was 62 months. OS rates were 73.6% and 51.5% at 2- and 5 years, respectively. The 2- and 5-year DFS rates were 68.3% and 62.8%. For patients with T3 disease, the 2-year OS rate was 79.5% and DFS rate was 70.2%. Patients with positive nodal status, N2b or above disease, stage IV disease and age greater than 60 years demonstrated poor OS on univariate analysis. Older age (HR 3.13; 95% CI 1.39- 6.98, p=0.005) and positive nodal status (HR 3.81; 95% CI 1.15-12.62, p=0.029) remained poor prognostic factors for survival on multivariate analysis. Functional preservation was 67.3% at 2 years in all patients alive (64.8% in T3 patients). 70% of patients treated with IMRT had a preserved larynx at 2 years versus 58.3% for 3D-conformal RT. The 2-year LEDFS rate was 47.4%. The