15 / 79
page 16
6th ICHNO
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
__________________________________________________________________________________________
average the GTV was 18.7cm
3
(range 6.4-66.7 cm
3
). All
patients had histological proven free bone tumor margins.
Analysis of the accuracy of the cutting planes showed that
the average deviation of the planned cutting plane was
2.1mm. Appr half of the cutting planes were closer placed
to the tumor than planned with an average shift of 1.98
and 2.5 mm measured on the most cranial resp. caudal
point
of
the
buccal
bone
surface.
Conclusions: This study reports a method for image fusion
and 3D surgical planning using the hospitals existing
software architecture. Tumor visualization by fusion of CT
and MRI for integration of tumor margins seems a safe
method in 3D virtual planning of surgical removal of oral
squamous cell carcinoma. This approach allows us to
visualize not only tumors but also other useful information
for surgical planning such as radiotherapy isodose lines
SP-025 Oropharyngeal surgery
T. Jones
1
1
University of Liverpool, Department of Molecular and
Clinical Cancer Medicine, Liverpool, United Kingdom
Abstract text
Over recent decades the incidence of oropharynx cancer
(OPSCC) has doubled in many countries of the Developed
World. Whilst much of this increase has been attributed to
infection with Human papillomavirus (HPV+), recent UK
data confirm a parallel rise in HPV negative OPSCC. HPV+
OPSCC affects patients who are younger, fitter, drink less
alcohol and smoke less than patients presenting with HPV-
head and neck cancer. Whilst they typically present with
clinico-pathological features (multiple cervical lymph
nodes with a high prevalence of extracapsular spread)
traditionally associated with aggressive behaviour and
poor treatment outcome, they, paradoxically, respond
better to treatment. Current treatments based on
cisplatin based chemoradiotherapy (CRT), however, result
in marked early and late toxicity, particularly with respect
to swallowing function. Whilst most patients with HPV+
disease will experience a favourable survival outcome, a
significant minority, together with patients presenting
with HPV- disease, will do less well.
This talk will highlight the contribution of contemporary
surgery in the quest to develop novel
1. De-intensified treatment strategies for patients with
favourable disease, in order to maintain current survival
outcomes whilst reducing detrimental treatment-related
effects on swallowing
2. More effective strategies for patients likely to
experience a poorer outcome.
Poster discussion
PD-026 Correlation and prognostic impact of HPV and
p16 on RT-outcome in larynx and hypopharynx cancer
P. Lassen
1
, M. Schou
1
, J. Overgaard
1
, J. Alsner
1
1
Aarhus University Hospital, Department of Experimental
Clinical Oncology, Aarhus C, Denmark
Purpose or Objective
HPV has been found in head and neck cancer from all sites
with a significantly higher prevalence in oropharyngeal
carcinoma (OPC) compared to non-OPC. In previous
randomised trials HPV-associated p16-expression has been
shown to be the strongest independent factor for
radiotherapy (RT) outcome in OPC. Outside OPC the
correlation between HPV and p16 is less robust and the
prognostic significance of p16/HPV less obvious. Previous
analysis on DAHANCA patients found no prognostic impact
of p16 outside OPC, but others have reported conflicting
findings. With this study we wanted to investigate the
correlation between HPV and p16 in advanced larynx and
hypopharynx cancer and furthermore to analyse the
potential prognostic impact of both markers on overall
survival after primary, curatively intended RT.
Material and Methods
One-hundred-nine patients with stage III-IV larynx and
hypopharynx carcinoma were identified in the DAHANCA
database. All patients were treated with curatively
intended primary RT according to DAHANCA guidelines
from 1986-2006. The patient cohort was enriched for p16-
positive tumors and as such not representative for
unselected patients. Pre-treatment tumour blocks were
evaluated by immunohistochemistry for p16-expression
and classified as positive in case of strong cytoplasmatic
and nuclear staining in >70% of tumor cells and in
consideration of the typical microscopic appearance of an
HPV-related tumor. HPV DNA and RNA was analysed by
qPCR using specific primer sets for HPV16 E6 and E7 and
HPV18 E6 and E7. Internal reference genes were
ERV3-1
and
HBB
for DNA and
ACTR3
,
NDFIP1
, and
RPL37A
for RNA.
Results
Twenty-six percent (19/74) of larynx cancers and 14% of
hypopharynx cancers (5/35) were p16-positive. All p16-
positive hypopharynx cancers were also positive for both
HPV DNA and RNA. Of the 19 p16-positive larynx cancers
only 1 was HPV DNA and RNA positive and 1 was HPV DNA
positive but RNA negative. Only HPV subtype 16 was
detected in case of HPV positivity. All p16-negative tumors
were HPV-negative, regardless of tumor site. In univariate
analysis overall survival was significantly associated with
HPV/p16-status in hypophaynx: HR: 0.30 [95% CI: 0.09-
0.99], whereas in tumors of laryngeal origin no prognostic
impact of p16–status was found: HR 0.85 [0.46-1.60]. See
Figure 1.
Conclusion
Our findings indicate a strong correlation between HPV
and p16-status in hypopharynx cancer where there also
seem to be a significant impact of the markers on overall
survival after primary RT comparable to what is seen in
OPC. Although no firm conclusions can be drawn due to
the limited sample size, we find that there is a need for
more investigation in the subject in order to enable proper
definition of the group of patients with HPV-associated
tumors and favourable prognosis, both in OPC and
hypopharynx.
PD-027 cfHPV DNA as a marker of treatment results in
patients with HPV-related head and neck cancer.
T. Rutkowski
1
, A. Mazurek
2
, M. Snietura
3
, A. Wygoda
1
, M.
Kentnowski
1
, P. Polanowski
1
, U. Dworzecka
1
, B. Pilecki
1
,
K. Dębiec
1
, I. Gawron
1
, J. Niedziałek
1
, W. Pigłowski
3
, U.
Bojko
2
, P. Widłak
2
, K. Składowski
1
1
Maria Sklodowska-Curie Memorial Cancer Center and
Institute of Oncology, Department of Radiation
Oncology, Gliwice, Poland
2
Maria Sklodowska-Curie Memorial Cancer Center and
Institute of Oncology, Center for Translational Research
and Molecular Biology of Cancer, Gliwice, Poland
3
Maria Sklodowska-Curie Memorial Cancer Center and