24 / 79
6th ICHNO
page 25
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
__________________________________________________________________________________________
initial radiotherapy planning Computed Tomography
studies to identify the localization of recurrence.
Furthermore, patient and treatment characteristics were
correlated with the regional recurrences to identify risk
factors.
Results
The median follow-up in our study was 26 months. Overall-
and disease-specific survival at 2 years were 71.2% (95% CI
65.3-77.1) and 64.2 % (95% CI 59.2-69.3), respectively.
Local, regional and distant control at 2 years was 84.1%
(95% CI 79.1-89.2), 89.2% (95% CI 84.3-94.1) and 83.2%
(95% CI 76.3-90.1), respectively.
The actuarial rate of recurrence in the electively
irradiated lymph node regions was 3.9% (95% CI 1.8-6.0) at
2 years. No significant associations could be observed
between recurrence in electively irradiated lymph node
regions and age, gender, tumor site, stage, or the
presence of human papillomavirus in oropharyngeal
cancers (table 1).
Conclusion
The actuarial rate of recurrence in the electively
irradiated lymph node regions was 3.9% (95% CI 1.8-6.0) at
2 years. This incidence is comparable to recurrence rates
after standard dose of 50 Gy, suggesting that lower doses
to the elective neck do not result in higher regional
recurrences.
Debate: Early stage HPV related oropharyngeal cancer
should not be treated with radiotherapy anymore
SP-046 Early stage HPV related oropharyngeal cancer
should not be treated with radiotherapy anymore: for
the motion
C. Simon
1
1
Centre Hospitalier Universitaire Vaudois, Lausanne Vaud,
Switzerland
Abstract text
Early stage oropharyngeal cancer is a rare disease with a
very favorable prognosis. Current treatment guidelines
recommend either radiation therapy-only or surgery-only
as treatment options and the analysis of the literature fails
to demonstrate any difference in terms of oncological
outcome for the two modalities. Given that patients with
this disease will likely be cured, it seems critical to choose
a treatment, which provides excellent short- and long-
term functional recovery and quality-of-life. Whilst no
level 1 evidence yet exists as to which treatment will
perform better in this regard, concerns over radiation
therapy-based treatments have been raised as a
consequence of reported late toxicities. Within this
debate the pros and cons of surgery-based treatment for
early stage oropharyngeal cancer will discussed and
arguments presented, favoring surgery as the primary
modality of treatment for this disease.
SP-047 Early stage HPV related oropharyngeal cancer
should not be treated with radiotherapy anymore
against the motion
V.Budach
Germany
Abstract not received
SP-048 Early stage HPV related oropharyngeal cancer
should not be treated with radiotherapy anymore: for
the motion
J. Klozar
1
1
University
Hospital
Motol,
Department
of
Otorhinolaryngology- Head and Neck Surgery- First
Medical Faculty, Prague 5, Czech Republic
Abstract text
The use of one modality in the treatment of early stage
head and neck cancer represents an advantage for the
patient regarding the toxicity and the possible use of other
modalities in case of recurrence or second primary.
Despite of the lack of direct comparative studies primary
radiotherapy and surgery are considered to provide
comparable survival in early stage oropharyngeal tumors
both in the group of HPV positive and negative tumors. Up
to date HPV status should not influence the choice of
treatment modality. Ongoing clinical trials are supposed
to answer the question of possible de - escalation of
treatment in HPV positive tumors. There is a general
agreement that HPV status is the most important
prognostic factor in oropharyngeal cancer. Patients with
HPV positive tumors are usually younger and have better
survival hence the quality of life after treatment becomes
more important in this group of patients. Radiotherapy
particularly when combined with chemotherapy has a
known acute and late toxicity and leads in considerable
part of patients to xerostomia, deterioration of teeth and
dysphagia. The newly developed surgical techniques are
able to treat radically the early stage oropharyngeal
cancer without the need of adjuvant therapy. Transoral
laser surgery, ultrasonic surgery or robotic surgery even in
combination with some external approaches like neck
dissection result in better quality of life and should be
therefore preferred.
SP-049 Early stage HPV related oropharyngeal cancer
should not be treated with radiotherapy anymore
against the motion
J. Giralt
1
1
Hospital Universitario Vall d'Hebron, Barcelona, Spain
Abstract text