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ESTRO 36
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Material and Methods
We analized the incidence of local side -effects during
adyuvant radiotherapy treatment in 24 locally advanced
laryngeal cancer patients who underwent laser
microsurgery.
In terms of TNM classification 14 patients were T3 stage
and
10
patients T4a
stage.
In 20 patients chemotherapy was associated to radiation
(83%)
The incidence of acute local side -effects during
Radiotherapy treatment were analized according to the
following factors: Laryngeal mucositis grade (RTOG scale);
Swallowing dysfunction meassured by Visual Analogue Pain
Scale; Radiation treatment duration and early
discontinuation of Radiation treatment.
All patients were treated with IMRT technique
Results
We observed an increased acute toxicity in this group of
patients compared to those who underwent
chemoradiation alone or associated to larynguectomy.
Ten patients presented grade 3 or 4 mucositis during the
treatment (41%)
The grade of swallowing dysfunction were up to 5 in all
patients and up to 8 in 6 (20%) meassured in a 1 to 10 pain
scale.
The median treatment duration were 45 days, that reveals
an increase compared to conventional cohort (48%)
Five patients required definitive early suspensión of
treatment (20%).
Eight patients underwent percutaneous gastrostomy when
the weight-loss was above 15%.
Three patients underwent tracheotomy due to severe
glottic stenosis produced by edema (12%).
Conclusion
In our experience Transoral Laser Microsurgery with
adyuvant Radiotherapy in advanced laryngeal cancer
patients has increased side-effects.
We do not recommend this association
EP-1095 Combined induction chemotherapy and
radiotherapy in locally advanced nasopharyngeal
carcinoma.
A. Gevorkov
1
, A. Boyko
1
, L. Bolotina
2
, A. Kornietskaya
2
,
T. Deshkina
2
1
Moscow Research Gerzen Oncology Institut, Radiation
oncology, Moscow, Russian Federation
2
Moscow Research Gerzen Oncology Institut,
Chemotherapy, Moscow, Russian Federation
Purpose or Objective
This prospective trial was conducted to evaluate the
efficacy and toxicity in previously untreated patients with
stage III-IV nasopharyngeal carcinoma who received an
induction chemotherapy followed by radiotherapy.
Material and Methods
From January 2004 to December 2010, 50 patients with
T2-4N2-3M0 squamous cell carcinoma of the nasopharynx
were treated with three or six cycles of docetaxel 75
mg/m2 (1-st day), cisplatin 75 mg/m2 (1-st day),
doxorubicin 45 mg/m2 (1-st day) (50 patients) followed by
radiotherapy using the conventional time/dose schedule.
Results
The response rate to chemotherapy was 88% (48%
complete response [CR]; 40% partial response [PR]), and
the overall CR rate after radiotherapy was 92%. With a
median follow-up period of 90 months, the 3-year survival
rate was 63,6% and 3-year loco-regional control was 45,8%.
The 5-year survival rate was 58% and 5-year loco-regional
control was 42%. Treatment was tolerated, but with
significant acute or chronic toxic effects and radiotherapy
treatment gaps.
Conclusion
The results of this study demonstrate that docetaxel,
cisplatin and doxorubicin followed by radiotherapy can
induce a durable remission in a high proportion of patients
with poor-prognosis stage III-IV nasopharyngeal
carcinoma. Treatment may be associated with severe
toxicity
and
unplanned
irradiation
delays.
EP-1096 Using DIR to study patterns of loco-regional
failure in patients with head and neck cancer
Y. Zheng
1
, D.J. Noble
2
, R. Jena
2
, N. Burnet
2
1
Addenbrooke's Hospital- Cambridge University Hospitals
NHS Foundation Trust, School of Clinical Medicine,
Cambridge,
United Kingdom
2
Addenbrooke's Hospital- Cambridge University Hospitals
NHS Foundation Trust, Department of Oncology- Cancer
Research UK VoxTox Research Group, Cambridge, United
Kingdom
Purpose or Objective
Using deformable image registration (DIR), we examined
patterns of loco-regional failure in patients who had
undergone IMRT with daily image guidance for head and
neck squamous cell carcinoma (HNSCC).
Material and Methods
A database of HNSCC patients recruited to the Cancer
Research UK VoxTox study between March 2013 and
January 2016 was reviewed. All patients had been treated
on TomoTherapy units, according to local protocol.
Inclusion criteria for this sub-study were: full details of
treatment protocol (RT and chemo) available, adequate
follow-up, confirmed residual or loco-regionally relapsed
disease, and diagnostic quality imaging of this disease
(including MRI, PET/CT, CT) available for review. This
gave a final cohort of 12.
Imaging confirming relapse or residual disease was
uploaded to virtual simulation software (Prosoma 3.3),
where an in-built DIR package was used to fuse these
images with the planning CT and treatment dose-cube.
Residual/relapsed disease was contoured on the relapse
imaging, named rGTV, and the volume of this structure
recorded. Contours describing the 95% isodose of 65Gy,
60Gy, 55Gy and 54Gy where relevant were generated. For
each case, the proportion of rGTV covered by these
isodoses and the treatment PTV and CTVs were recorded
(labelled ‘V’). Relapses were classified according to the
95% isodose of prescription dose contour: ‘in-field’ V >
75%, ‘marginal’ V – 25-75%, ‘out of field’ V < 25%.
Results