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6th ICHNO
page 19
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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stages I and II. All patients received radiotherapy, of which
62% were given 3DRT technique and 38% IMRT technique.
Surgery was performed 34%, and 40% underwent neck
dissection. Most relevant results are described in Table 1.
There were differences in cognitive functioning according
stage and neck dissection. Physical functioning was
related with age and primary tumour surgery. Emotional
scale was also related with surgery. Global quality of life
and fatigue were worst in >65 years’ patients. Senses
problems were linked to stage and surgery. There were
more teeth problems regarding location. Dry mouth was
related to stage and location of the tumour. Problems in
opening mouth were also related to stage. Teeth problems
were linked to location. Sticky saliva is found in active
smokers. Regarding health status, we found larger
sedentary hours in non-smokers. There were no
differences between groups in MUST score, although 14%
of patients were at high risk of malnutrition.
Cardiovascular risk was high or very high in 62% of the
patients. AUDIT score showed no problems with alcohol in
the 88% of the patients. We found high prevalence of
psychological symptoms (56% for anxiety and 46% for
depression), with no differences between groups. There
were also more not working patients related to surgery
and location of the tumour.
Conclusion
Our study indicates that clinical and therapeutic
characteristics impact on the quality of life of HNC
survivors. We have found non covered needs in physical,
emotional and cognitive spheres, and in clinical issues
regarding local symptoms.
PD-032 Pharyngeal constrictor muscle dose correlated
with dysphagia after radiotherapy in head and neck
J. Miroir
1
, J. Biau
1
, N. Saroul
2
, C. Millardet
1
, M. Lapeyre
1
1
Centre Jean Perrin, radiation oncology, Clermont
Ferrand, France
2
CHU Gabriel Montpied, head and neck cancer, clermont
ferrand, France
Purpose or Objective
Dysphagia is one of the main sequellae of radiotherapy for
head and neck cancers. The aim of this prospective study
was to to identify predictive factors of dysphagia in
patients treated with intensity modulated radiotherapy
(IMRT).
Material and Methods
Between 2011 and 2015, 226 patients (90 oropharynx, 48
oral cavities and 70 pharyngo-larynx, 11 nasopharynx and
7 unknown primary) were treated with IMRT with bilateral
neck irradiation. Hundred had postoperative IMRT and 133
patients received concurrent chemotherapy. Prognostic
factors studied were: the pharyngeal constrictor muscle
mean dose, the larynx mean dose, age, location, tumor
stage, xerostomia, mucositis, surgery, and concurrent
chemotherapy.
Results
The median follow up was 17 months. The one year loco
regional control and overall survival were 81 and 77%
respectively.
At 3 monts and one year, grade ≥ 3 dysphagia were 34 and
13% respectively. The average duration of enteral feeding
was 209 days and was correlated with the pharyngeal
constrictor muscle mean dose (p = 0.012). Acute dysphagia
grade ≥ 3 was influenced by the concurent chemotherapy
(p <0.001), pharyngeal constrictor muscle mean dose (>
55Gy, p = 0.014), mucositis (p <0.001), xerostomia (p =
0.0013), age <55 years (p = 0.016) and a location other
than pharyngo-larynx (p <0.001). In multivariate analysis,
only mucositis (grade 3-4; OR: 7.85), the concurent
chemotherapy (OR: 5.75) and location other than
pharyngo-larynx (OR: 0.19) were independent prognostic
factors. At 1 year, in univariate and multivariate analysis,
only the pharyngeal constrictor muscle mean dose was an
independent prognostic factor with a threshold at 55Gy
(19% vs 4%, P = 0.037, OR: 4.73).
Conclusion
The acute dysphagia is related to concurent
chemotherapy.Pharyngeal constrictor muscle mean dose >
55 Gy is associated with the risk of long-term dysphagia
grade ≥ 3 .
PD-033 Cetuximab + RT shows an excellent long term
OS in patients with both high ADCC and high EGFR
M. Merlano
1
, L. Lattanzio
1
, N. Denaro
1
, D. Vivenza
1
, G.
Milano
2
, R. Vigna Taglianti
3
, A. Merlotti
3
, M. Ferrero
1
, C.
Lo Nigro
1
1
Azienda Ospedaliera S. Croce e Carle, Oncology, Cuneo,
Italy
2
Antoine Lacassagne Cancer Institute,
Oncopharmacology, Nice, France
3
Azienda Ospedaliera S. Croce e Carle, Radiotherapy,
Cuneo, Italy
Purpose or Objective
Cetuximab induces ADCC, but the clinical relevance of this
additional mechanism of action is unknown.
In a multi-step proof of concept project we investigate the
impact of individual ADCC activity in pts treated with
cetuximab and radiotherapy (BRT) on the following
outcome, by itself or in function of the cetuximab target
EGFR.
In the present up-date, we investigated the role of ADCC
perturbation during therapy, the relationship between