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S596
ESTRO 36
_______________________________________________________________________________________________
Widłak
3
1
Maria Sklodowska-Curie Memorial Cancer Center and
Institute of Oncology III Dept., Department of
Radiotherapy, Gliwice, Poland
2
Maria Sklodowska-Curie Memorial Cancer Center and
Institute of oncology iii dept., i radiation and clinical
oncology department, gliwice, polan
3
maria sklodowska-curie memorial cancer center and
institute of oncology iii dept., center for translational
research and molecular biology of cancer, gliwice,
poland
4
maria sklodowska-curie memorial cancer center and
institute of oncology iii dept., tumor pathology
department, gliwice, poland
5
maria sklodowska-curie memorial cancer center and
institute of oncology iii dept., department of
epidemiology and silesia cancer registry, gliwice, poland
Purpose or Objective
Despite of confirmed prognostic importance of human
papilloma virus (HPV) for patients with head and neck
cancer (HNC) such data based on Polish population is
scarce. The aim of the study was to estimate the ratio of
HPV related tumors in patients with HNC and to evaluate
the prognostic role of HPV in patients with pharynx or
larynx cancer treated with radiotherapy alone (RT) or in
combination with chemotherapy (CHRT) in the Cancer
Center-Institute in Gliwice, Poland between 2012 and
2014.
Material and Methods
322 consecutive patients with HNC (nasopharyngeal
cancer (NPC) 25 (7.8%), oropharyngeal cancer (OPC) 125
(38.8%), hypopharyngeal cancer (HPC) 36 (11,2%),
laryngeal cancer (LXC) 132 (41%), cancer of unknown
primary (FPI) 4 (1,2%)) treated radically with RT (121/38%)
or CHRT (201/62%) have been included. HPV etiology has
been confirmed basing on tissue material and/or
circulating-free DNA HPV. The ratio of HPV-related tumor
has been estimated in all group and in OPC patients.
Patients with OPC HPV-related (HPV+) and HPV-not
related (HPV-) were compared acc. to other prognostic
factors. Three-years local (LC), nodal (NC) control survival
rates and disease-free (DFS), distant metastases-free
(DMFS) and overall survival (OS) rates were compared for
patients with OPC (HPV+) and OPC (HPV-).
Results
Median follow up was 36 months. HPV-related tumors have
been confirmed in 72 (23%) patients, in 3 (4.2%), 58
(80,5%), 1 (1,4%), 9 (12,5%), 1 (1,4%) of patients with NPC,
OPC, HPC, LXC and FPI respectively. In OPC patients these
with HPV+ and HPV- did not differ by sex and the age. OPC
(HPV-) were smokers more often (p=0,0007). T stage in
both groups was similar, but N stage was significantly
higher in (HPV+) (p=0.03). Patients with OPC (HPV+) had
significantly higher 3-year LC (91% v 72%, p=0,006), NC
(90% v 70%, p=0,008), DFS (85% v 63%, p=0,008) and OS
(78% vs 66%, p=0,17). 3-year DMFS was the same in both
groups (93% v 94%, p=0.6). In multivariate analysis HPV
appeared to be an independent factor influencing
OS ratio.
Conclusion
HPV-related tumors in Polish patients with HNC could be
found in a similar percentage like in other countries,
reaching almost half of patients with OPC. Polish patients
with OPC (HPV+) are not so young but do not smoke and
present higher advanced nodal stage. Our findings
confirm that HPV is a strong, independent and beneficial
prognostic factor in Polish patients with OPC.
EP-1084 Laryngeal preservation using chemo-
radiotherapy, single institution experience from Egypt.
A. Al Nagmy
1
, T. Shouman
1
, A. Hassouna
1
, M. Gaber
2
1
Cairo University- National Cancer Institute, Radiation
Oncology Department, Cairo, Egypt
2
Cairo University- Faculty of medicine, Clinical Oncology
Department, Cairo, Egypt
Purpose or Objective
to evaluate organ preservation by radical radiotherapy ±
chemotherapy (CT) in locally advanced laryngeal cancer
Material and Methods
we reviewed medical records of 71 patients with locally
advanced laryngeal cancer (T3-4 or N+) treated at the
Radiation Oncology Department, National Cancer
Institute, Cairo University, Egypt, during the period from
2007 to 2013 inclusively. Prognostic factors, treatment
modalities, and their effect on loco-regional control (LRC)
and overall survival (OS) were studied.
Results
mean age was 61 years. Smoking history was present in
94% of patients. Squamous cell carcinoma was the most
common pathological type (98%). Glottic carcinoma
represent 31%, supraglottic carcinoma represent 60.5%,
while transglottic carcinomas represent 8.5% of patients.
Prescribed radiotherapy dose was 70Gy/35 fractions/7
weeks. Combined chemoradiotherpy was used in 72%,
while radiotherapy alone was used in 28% of patients.
Concurrent chemotherapy regimens used were weekly
Cisplatin (93%), weekly Carboplatin (5%), and Cisplatin
D1,22,43 (2%). Twenty five patients received induction
chemotherapy (IC); mostly Docetaxel/Cisplatin/5-FU
(TPF) protocol (17 patients). The majority of patients
(64%) achieved complete remission (CR). Locoregional
failure was reported in 4 patients, and salvage surgery was
done for those patients. The 3-year LRC and OS rates were
73% and 46.3% respectively. The only adverse prognostic
factor affecting OS was poorly differentiated tumors
(P=0.05). Other factors which did not significantly affect
LRC or OS were pretreatment Hemoglobin (P=0.14), T
stage (P=0.52), nodal stage (P=0.10), radiotherapy
machine used (P=0.09), received dose of RT (P=0.14), dose
per fraction (P=0.68), gaps during RT (P=0.10), use of IC
(P=0.32), and time interval between IC and RT (P=0.47).
Laryngectomy free survival (LFS) rate at 2 and 3 year were
42% and 34% respectively.
Conclusion
Concomitant chemoradiotherapy is an effective modality
for organ preservation in advanced laryngeal cancer with
LFS 42% which can be further improved by better selection
of patients. The poorly differentiated tumors significantly
affect OS.
EP-1085 Comparative study of outcomes and toxicities
in conventional 2DRT vs IMRT in locally advanced
HNSCC
K. Periasamy
1
, P. Baskaran Shanmuga
2
, S. Sambasivam
1
,
T.P. Soni
1
, N. Patni
1
, G.K. Singh
2
, J. Kaur
2
, A. Gupta
2
,
K.T. Bhowmik
2
1
Bhagwan Mahavir Cancer Hospital and Research Center,
Radiation Oncology, Jaipur, India
2
Safdarjung Hospital, Radiation Oncology, New Delhi,
India
Purpose or Objective
To compare conventional 2DRT with intensity modulated
radiation therapy (IMRT) in locally advanced head-neck
squamous cell carcinoma (HNSCC) patients treated with
curative-intent chemoradiation (CRT) with respect to
treatment outcome and toxicities.
Material and Methods
This bi-institutional study is a retrospective comparative
analysis of patients with biopsy-proven locally advanced
HNSCC (stage III-IV) who were treated either with
conventional 2DRT or IMRT to a radiation dose of 66-70 Gy
with concurrent chemotherapy. In this study the
treatment response to CRT, treatment related acute and