6th ICHNO Abstract Book

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6th ICHNO page 23
6th ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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with promising local control rates especially in advanced
ACC. The use of tumour debulking in advanced ACC may
have to be reconsidered. In cases of local tumour relapse,
C12 may be a good option when surgery is not feasible but
has to be used with caution.
Proffered papers 3
OC-042 Re-irradiation with curative intent of squamous
cell carcinomas of the head and neck in Denmark
B.E. Engelmann1, M. Andersen2, C. Elmann3, M. Farhadi1,
A. Gothelf4, C.R. Hansen 3, K. Nowicka-Matus5, J.B.B.
Petersen6, E. Samsøe1 , H.M. Sand2, B. Smulders4, J.
Johansen 3
1Herlev Hospital, Department of Oncology, Herlev,
Denmark
2Aalborg University Hospital, Department of Oncology,
Aalborg, Denmark
3Odense University Hospital, Department of Oncology,
Odense, Denmark
4Rigshospitalet Copenhagen University Hospital,
Department of Oncology, Copenhagen, Denmark
5Aarhus University Hospital, Department of Oncology,
Aarhus, Denmark
6Aarhus University Hospital, Department of Medical
Physics, Aarhus, Denmark
Purpose or Objective
To review outcomes of patients with recurrent squamous
cell carcinoma of the head and neck (SCCHN) treated in
five Danish institutions with definitive re-irradiation
(RRT).
Material and Methods
We retrospectively reviewed the medical records and data
from the Danish Head and Neck Cancer Database
(DAHANCA) of patients with unresectable loco-regional
recurrent or new primary SCCHN treated with definitive
RRT with or without chemotherapy from January 1, 2007
through December 31, 2014 at five oncology centers in
Denmark. The primary aim was to analyze disease-specific
survival (DSS) and overall survival (OS) in a defined cohort
and to report patient characteristics, cumulative radiation
doses and systemic treatment.
Results
We identified 73 patients that received IMRT-based RRT.
The predominant symptoms were dysphagia (22%) and pain
(46%). 75% were recurrent stage IV. 74% were either
pharyngeal cancer or a localized neck recurrence. RRT of
42-68 Gy resulted in cumulative radiation doses between
70 to 142 Gy (median 120 Gy). The majority was treated
with hyperfractionated RRT; 41% received concomitant
chemotherapy (median 5 cycles) and 35 patients (48%) had
surgery at some point. Only one patient terminated
treatment prematurely, all others completed the full
treatment course.
The most prevalent side effects were difficulty swallowing
(37%), grade 3 mucositis (29%), and 24 patients had a
nasogastric feeding tube, which was permanent at last
follow-up in 10.
Survival data were available for 70 patients. With a
median follow-up for death of 15.8 months (range 1.4-
100.7), the 5-year DSS was 35% and the 5-year OS 27%.
Twenty-four patients (34%) were still alive at the end of
the study.
Conclusion
This nation-wide study confirms that IMRT-based RRT can
achieve long-term disease-control in a about one third of
patients with recurrent SCCHN. Compliance to definitive
multimodality treatment was high and the data support
the use of RRT for SCCHN patients as a salvage treatment
approach.
OC-043 Re-irradiation in head and neck cancers: A
single institution prospective cohort study
R. Salunkhe1, S. Ghosh Laskar1, S. Chakraborty1, T. Gupta1,
A. Budrukkar1, V. Murthy1, J.P. Agarwal1
1Tata Memorial Hospital, Radiation Oncology, Mumbai,
India
Purpose or Objective
To report the patterns of care and outcomes of patients
of recurrent head neck cancer receiving re-irradiation
(reRT) in a prospective cohort treated at a tertiary cancer
care center in India.
Material and Methods
Since January 2014, 180 (male-150 , female- 30) patients
were screened and prospectively accrued on this IEC
approved study, after obtaining informed consent.
Treatment decisions were taken in a multidisciplinary
clinic. Analysis was conducted on 164 patients in whom
treatment details after diagnosis of recurrence were
available. Descriptive analyses conducted included
frequencies for categorical variables and median (range)
for continuous variables. Survival was estimated using the
Kaplan Meier method. Propensity score matching using
nearest neighbour matching was used to match patients
who received and did not receive reRT with respect to
variables of age, gender, site and stage of recurrence,
disease free interval, nature of recurrence (second
primary / true recurrence) and if the patient underwent
surgery. Outcomes data was also calculated for the
matched group.
Results
The median age was 56 yrs (17-95yrs). Oral cavity was the
commonest site of the recurrence (n = 90, 55%). The
median follow-up of the entire cohort was 12 months. 110
patients were treated with Surgery with / without
adjuvant reRT, while definitive re-irradiation was offered
to 37 patients (33%). 17 patients (10%) received
chemotherapy or best supportive care only.
Most common cause of not considering reRT (n=53, 32%)
were high grade of late toxicities (n=24, 45% ) and
extensive nature of recurrence (n= 12, 23%). All patients
received re-RT with EBRT and the median dose delivered
was 60Gy. Conformal techniques were used in 91 patients
(88%) mainly in the form of IMRT (94%) and 3DCRT (6%)
Concurrent chemotherapy was given in 16 patients(10%).
Median overall survival (OS) was not reached, while the
median progression free survival (PFS) was 14.9 months
(95% CI: 13.6 - 20.9 months). PFS was significantly better
in patients receiving reRT (20.0 vs 10.5 months, p = 0.003).
This benefit was maintained in the 106 patients in the
propensity score matched group (median PFS 34.4 vs 23.6
months, p = 0.01). Grade III - IV late toxicities were seen
in 11 patients (10.2%), mostly in the form of subcutaneous
fibrosis.