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6th ICHNO
page 29
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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hypofractionated radiotherapy 55 Gy in 20 fractions over
4 weeks for glottis carcinoma.
Material and Methods
Patients aged over 70 years and treated for glottic cancers
with definitive radiotherapy, between 2007 and 2014,
were retrospectively identified. Characteristics reflective
of fitness (smoking status, performance status and ACE 27
score) as well as tolerance (compliance with radiotherapy,
need for acute hospitalisation during treatment, need for
enteral feeding, 30-day mortality) were collected. The
probabilities of local control, disease free and overall
survival were calculated using Kaplan-Meier statistics.
Univariate Cox Regression investigated factors potentially
important in outcome.
Results
53 patients were identified. Median age was 76 years (71
– 91). Median follow up was 40.1 months (range 1.1 -103.3
months). 24 (45%), 26 (49%) and 3 (6%) had T1, T2 and T3
disease respectively. Two and three year local control,
DFS and OS rates were 85%, 80% and 76% and 83%, 77% and
71% respectively. On univariate analysis, there was no
significant difference in outcomes for T1 and T2 disease:
2-year local control and DFS were 85%, 84% for T1 and 89%
and 89% for T2 respectively. No other factors (e.g. age,
gender, T-stage or histological grade) significantly
influenced local control, DFS or OS, with the exception of
ACE 27 Score (0-1 versus 2-3), which significantly
influenced overall survival (ACE 27 score 2/3 vs 0/1:
hazard ratio: 2.65, 95% confidence interval 1.22-5.77,
p=0.014). All patients were able to complete their course
of treatment with 6/53 patients experiencing a treatment
delay of >3 days (median 28 days (26-34)). A total of 11/53
(21%) patients required hospital admission during
treatment; 9 (17%) for enteral tube feeding and 2(4%) for
symptom management. 30 day mortality was 0%. All 8
patients with a local recurrence were offered salvage
options. Of these 5 patients underwent salvage surgery
with 2 recurrences (1 local, 1 distal)and 3 patients disease
free on follow up; 3 refused salvage surgery.
Conclusion
Patients aged over 70 years tolerate definitive
hypofractionated radiotherapy with high rates of local
control. Comorbidity scoring with the ACE 27 scale is an
independent prognostic factor for overall survival.
PO-057 Radiation induced skin reaction in head neck
malignancies and assessment of quality of life
V. Pareek
1
, M. Chandra
2
, R. Bhalavat
2
1
Jupiter Hospital- Thane, Radiation Oncology, Mumbai,
India
2
Jupiter Hospital, Radiation Oncology, Thane, India
Purpose or Objective
To evaluate the skin reactions in patients receiving head
and neck radiation and assessing the outcomes of the same
in respect to the modality of the treatment. Head and
Neck malignancies for the bulk of cancer cases in India and
Radiation therapy forms a part of management of the
same. With Radiation fractionations delivered either with
IMRT or 3DCRT, there is a risk of development of skin
reactions during the treatment period and can lead to
varying degree of complications i.e. infection, ulcerations
or even necrosis. The assessment of skin reactions needs
to be looked in to as it can be easily avoided with proper
prophylaxis and the progression can be managed at an
earlier stage. We present our institutional experience in
the treatment of the head and neck cancer case
treatment.
Material and Methods
In a prospective, non-randomized study of 100 histo-
pathologically proven head and neck cancer cases of
various subsites, planned for adjuvant radiation therapy,
were enrolled in our study. The patients were treated with
IMRT or 3DCRT plan for External beam radiation therapy
to standard dose of 60Gy in 30 fractions with 200cGy dose
5 times a week over 6 weeks. Of the 50 cases, 26 received
adjuvant chemotherapy. The patients were given EORTC
Qol 30 and QoL HN 35 at start of treatment, at completion
of radiation therapy and subsequently at 1 month and 3
months of follow up. The skin reactions were assessed
using EORTC and CTCAE 3.0 toxicity grading scales. The
scores were analyzed and subsequently the toxicity grades
were looked in to and compared and outcome was
assessed.
Results
Out of the 100 patients, 76 developed skin toxicity as per
the scales; of which 56 developed grade I toxicity and 20
developed grade II toxicities. The questionnaires were
assessed with suitable statistical analysis and no statistical
significant was found in the 3DCRT or IMRT arms. However,
with increasing grade of tumor, the Qol showed a
significant difference in the physical and functional
symptoms. The skin toxicity too showed a statistically
significant outcome with varying grades of the tumor
assessed. The evaluation of toxicities and subsequent
management reveleaed better outcomes in the QoL at the
end of 3 months wherein the acute form of the toxicities
subsided. None of them developed grade 3 or 4 skin
toxicities
Conclusion
The morbidity associated with skin reactions related to
radiation therapy in head and neck malignancies were high
in 2D era and now with advent of conformal therapy there
is a reduction in the cases of the same. However, the
incidence can still be reduced further with proper review
of patients during treatment and assessment of quality of
life. The acute reactions can be prevented to develop in
to chronic complications which increase further the
morbidity of such patients. Appropriate management of
such cases at the right time helps in improving the quality
and make the treatment an even better option.
PO-058 Nasopharingeal carcinoma treated with
intensity modulated radiotherapy in an non–endemic
area.
A. Lozano
1
, A. Navarro
1
, H. Letelier
1
, S. Vazquez
2
, V.
Navarro
3
, J. Nogues
4
, R. Mesia
5
1
Institut Català d'Oncologia, Radiation Oncology
Department, L'Hospitalet de Llobregat, Spain
2
Institut Català d'Oncologia, Medical Oncoly Department,
L'Hospitalet de Llobregat, Spain
3
Institut Català d'Oncologia, Clinical Investigation Unit,
L'Hospitalet de Llobregat, Spain
4
Hospital Unversitari de Bellvitge, Otorhinolaryngology
department, L´Hospitalet, Spain
5
Institut Català d'Oncologia, Medical Oncology
Department, L'Hospitalet de Llobregat, Spain
Purpose or Objective
NFC is frequent in some areas but not in Europe. There is
a few information in non-endemic population.
The aim of
this
study is to describe and analyze the results in treating all-
stages NPC with IMRT-simultaneous integrated
boost (SIB), in a non-endemic area.
Material and Methods
A retrospective review of 62 consecutive patients with
NPC
treated with curative intention with IMRT-
SIB between 2007-14 in a single institution.
RT scheme: 33 daily fractions,1.64 Gy to intermediate-
risk volume, 2.12 Gy to high-risk volume. Total dose
54.12 Gy and 69.96 Gy respectively.
Overall survival (OS),
loco-regional
relapse-
free survival (LRRFS), and progression free survival