6th ICHNO Abstract Book

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page 30 6th ICHNO
6 th ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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(PFS) and toxicity have been evaluated . Kaplan-Meier
method has been used.
Results
Median follow-up: 29.7 months. Median age 51
years (range, 15-78).
Mainly men (69%), Caucasian (77.4%) locally advanced
disease (93.5%) and undifferentiated (WHO III) (71%).
Epstein Bar Virus (EBV) positive in 40
p. (64.5%).Only 6 patients (10%) were treated exclusivel
y with RT, while the rest received
chemotherapy (CT), mainly concurrent (85%). Induccti
on CT was delivered to 71.% patients and/or
adjuvant CT to 36%
patients received neoadjuvant and adjuvant CT.
The 2 and 5 year OS was 84.0%- 61,3% , LRRFS: 97% and
93,7% and PFS were 81.5% and 60.4% respectively.
Main chronic toxicity was xerostomia G1 in 51% and G2 in
10%.
Conclusion
The treatment of NPC ( predominantly locally advanced
) using IMRT-SIB offer a result comparable to results
described in endemic population with minimal chronic
toxicity.
PO-059 Efficacy and safety of modified-increased FEP
regimen and chemo-radiation for locally advanced
HNSCC
A. Ouhajjou1, Z. Fadoukhair1, H. Faouzi1
1Oncology Center Alazhar, oncology, Rabat, Morocco
Purpose or Objective
The optimal sequencing of chemotherapy (CT), radiation,
and surgery in the management of locally advanced HNSCC
remains a subject of debate. To improve RR and functional
outcomes, CT has been added into various approaches.
These approaches have been applied for both patients
with unresectable cancers and those with resectable
disease who prefer organ preservation. Moreover, in the
large Meta-Analysis of CT on Head and Neck Cancer,
induction CT improved the rate of distant metastases and
the CCRT improved the locoregional and distant control.
Phase II and III trials using more intensive CT with three-
drug regimens demonstrated a better RR than two drugs.
To figure out if this promising three-drugs induction CT
followed by CCRT in locally advanced HNSCC is active and
safe, we evaluated induction CT using modified increased
doses of FEP regimen (Fluorouracil, Leucovorin,
Epirubicin, Cisplatin) followed by CCRT for locally
advanced HNSCC.
Material and Methods
Between January 2008 and January 2015, 13 patients with
histologically confirmed non mestastatic HNSCC were
treated with induction CT using 5-Fluorouracil 500 mg/m2
d1-4, Leucovorin 200mg/m2 d1-4, Epirubicin 35mg/m2 d1-
2, Cisplatin 25mg/m2 d1-4 associated to G-CSF, every
three weeks followed by CCRT at Alazhar Oncology Center
group in Rabat, Morocco. We performed retrospective
analysis for efficacy in terms of response rate and toxicity
profiles. Survival data were not mature enough to be
presented. Medical records were also reviewed for
clinicopathologic characteristics. 9 patients were locally
advanced (IIB-IVB) and 4 were recurrent HNSCC. Patients
were first treated with 3 cycles of induction chemotherapy
with increased doses FEP regimen (mid FEP). After
induction chemotherapy, weekly cisplatin was
administered concurrent with radiation. Radiation
consisted of 65-70 Gy to the planning target volumes of
the primary tumor and 45 -60 Gy to any positive nodal
disease using 1,8 Gy per fraction.
Results
The median age was 62 years and 86% were male. The
majority were diagnosed with locally advanced HNSCC
with performance status of 0 to 1. All patients received 2
to 3 cycles of induction chemotherapy based on 5-FU 500
mg/m2 d1-4, Leucovorin 200mg/m2 d1-4, Epirubicin
35mg/m2 d1-2, Cisplatin 25mg/m2 d1-4 with G-CSF every
3 weeks. Concerning response rates (RR), 46% achieved a
PR, 38% had a CR and 15% SD, whereas 1% could not be
evaluated due to loss of follow-up. The most common
adverse events were neutropenia, thrombocytopenia and
anemia. One patient developed renal failure. The adverse
events that occurred during treatment were predictable
and manageable. After completion of the whole
treatment, small residual tumors were noted either at the
primary site and / or neck.
Conclusion
Through this retrospective study, we were able to analyze
RR and safety of modified-increased FEP regimen followed
by chemo-radiation for locally advanced HNSCC in
Moroccan patients. Our results showed that this regimen
is feasible and
PO-060 Dose received by the pituitary gland during
irradiation of nasopharyngeal carcinoma
N. Sellami 1, W. Siala2, H. Daoud3, W. Mnejja3, T.
Sahnoun3, L. Farhat3, J. Daoud 3
1Hopital Habib Bourguiba, radiation therapy, Sfax,
Tunisia
2Habib Bourguiba, radiation therapy, sfax, Tunisia
3CHU Habib Bourguiba, radiation therapy, sfax, Tunisia
Purpose or Objective
Hypopituitarism is a commonly reported consequence of
external radiotherapy during the treatment of
nasopharyngeal carcinoma (NPC).The aim of this work was
to evaluate the dose received by the pituitary gland during
irradiation of NPC.
Material and Methods
This is a retrospective study including 91 patients treated
for nasopharyngeal carcinoma between 2011 and 2016 at
the department of radiotherapy; Habib Bourguiba hospital
at Sfax Tunisia. Radiation therapy was performed
according to a conformational technique. The prescribed
dose was 68-70Gy to the nasopharynx and the initially
involved nodes. A dose of 50Gy was deliverated to the rest
of cervical lymph nodes. We delineated all of the pituitary
gland and we studied the dose received: the minimum
dose (Dmin), the maximum dose (Dmax) and the mean
dose (Dmean). Then, we compared the different
parameters according to the tumor stage (TNM 2009).
Results
The average Dmin was 37,9Gy vs. 49,4Gy respectively for
T1-T2 and T3-T4 (p = 0.04).The average Dmean was 46,8Gy
vs. 55,5Gy respectively for T1-T2 and T3-T4 (p =
0.007).The average Dmax was 53,8Gy vs 59,7Gy
respectively for T1-T2 and T3-T4 (p = 0.02).
Conclusion
The occurrence of pituitary disorders depends on the dose
received by the pituitary gland. Until now, there is no
consensus about the dose tolerance of this gland.
However, all published data agree that the maximum
delivered dose should not exceed 50Gy. Those doses are
generally outdated as was the case in our study. This is
because of the proximity of the target volume to the
pituitary gland. In fact, in our study, the dose received
was significantly higher for the T3-T4 group.
PO-061 Stomal underdose in post-laryngectomy
radiotherapy via VMAT: phantom study and clinical case
analysis
S. Lee1, J. Zhang2, B.K. Lee1, J. Cho-Lim2, W.S. Inouye2,
W.C. Lorentz3, M.Y. Leu3
1David Geffen School of Medicine at UCLA, Radiation
Oncology, Los Angeles- CA, USA