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page 36
6th ICHNO
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
__________________________________________________________________________________________
Conclusion
Induction chemotherapy followed with concurrent chemo
radiotherapy and adjuvant chemotherapy is feasible
treatment, but with high rate of severe acute toxicity
grade 3/4.
PO-073 Viable tumour in salvage neck dissections:
relation with initial treatment, lymph node size and HPV
K. Van den Bovenkamp
1
, B. Dorgelo
2
, M.G. Noordhuis
1
,
B.F.A.M. Van der Laan
1
, B. Van der Vegt
3
, H.P. Bijl
4
, J.L.
Roodenburg
5
, B.A.C. Van Dijk
6
, G.B. Halmos
1
, E.M.D.
Schuuring
3
, J.A. Langendijk
4
, S.F. Oosting
7
, B.E.C. Plaat
1
1
UMCG University Medical Center Groningen, ENT Head
and Neck Surgery, Groningen, The Netherlands
2
UMCG University Medical Center Groningen, Radiology,
Groningen, The Netherlands
3
UMCG University Medical Center Groningen, Pathology,
Groningen, The Netherlands
4
UMCG University Medical Center Groningen,
Radiotherapy, Groningen, The Netherlands
5
UMCG University Medical Center Groningen, Oral and
Maxillofacial Surgery, Groningen, The Netherlands
6
UMCG University Medical Center Groningen,
Epidemiology, Groningen, The Netherlands
7
UMCG University Medical Center Groningen, Medical
Oncology, Groningen, The Netherlands
Purpose or Objective
The objective of this study was to identify predictive
factors for the presence of viable tumor and outcome in
therapeutic salvage neck dissections in head and neck
squamous cell cancer.
Material and Methods
Retrospective analysis of 87 salvage neck dissections after
radiotherapy alone (n=30), radiotherapy in combination
with carboplatin/5-FU (n=43) or with cetuximab (n= 14).
Results
Viable tumor was detected in 47% of all neck dissections
and was associated with poor survival. Univariate analysis
revealed initial treatment with radiotherapy alone (OR
7.12,
p
< .001), clinical suspicion of recurrence during
follow-up (OR 7.10,
p
= .015), increased lymph node size
(OR 28.16,
p
= .002), more extensive neck dissections (OR
8.70,
p
< .001), and human papillomavirus (HPV) negative
cancer (OR 7.76,
p
= .010) as predictors of viable tumor.
Decreased or unchanged but still enlarged lymph
nodes after chemoradiation was a predictor of a negative
neck dissection (OR: 0.11,
p
< .001).
Conclusion
Viable tumor in salvage neck dissections is associated with
reduced survival. Increased lymph node size especially
after radiotherapy alone for HPV negative cancers, is
associated with viable tumor in salvage neck dissections.
In case of decreased or unchanged lymph node size after
chemoradiation, watchful waiting could be considered.
PO-074 Concomitant chemoradiotherapy alone or with
induction chemotherapy in advanced head and neck
cancer.
R. Teixeira
1
, A. Cavaleiro
1
, P. Vieira
2
, F. Aveiro
2
, G.
Vieira
1
1
Quadrantes Funchal, Clinica de Radioncologia da
Madeira, Funchal, Portugal
2
Hospital Central do Funchal, Hemato-Oncologia,
Funchal, Portugal
Purpose or Objective
The purpose is to compare the treatment outcomes of
patients with locally advanced head and neck cancer
treated with Concomitant Chemoradiotherapy (CRT) alone
versus induction chemotherapy (IC) followed by CRT in a
retrospective study.
Material and Methods
From February 2009 to December 2015 patients with
nonmetastatic stage III-IV were evaluated in a
multidisciplinary board and assigned to CRT or IC followed
by CRT. IC consisted of TPF (cisplatin, docetaxel, and
fluorouracil), PF (cisplatin, fluorouracil), TCF
(carboplatin, Docetaxel, and fluorouracil) and TP
(cisplatin, docetaxel). The chemotherapy administered
concurrently to most patients was cisplatin, given days 1,
22 and 43. Adverse events were assessed according to the
common toxicity criteria of adverse events (CTCAE v. 4.0)
and survivals were estimated using Kaplan-Meier method.
Results
The median follow-up was 29 months. A total of 138
patients were treated, 78 (56,5%) with CRT and 60 (43,5%)
with IC followed by CRT.
At 3 years the overall survival for CRT versus IC followed
by CRT was 50, 4%
vs
34, 3%, respectively (p = 0,006). The
Local control at 3 years was also higher for CRT compared
to IC followed by CRT, 61%
vs
42,4% (p= 0,02). The most
common grade 4 toxicity during IC was leukopenia and
during QRT the hematologic and non-hematologic
toxicities were similar in both treatment modalities.
Conclusion
Results suggest that CRT was associated with higher
overall survival and local control and that IC did not
improve the distant control.
PO-075 Treatment of nasopharyngeal cancer: a Serbian
institututinal experience
T. Ursulovic
1
, N. Babovic
1
1
Institute for Oncology and Radiology of Serbia, Medical
Oncology, Belgrade, Serbia
Purpose or Objective
Since 2005.-2012. we have treated patients with
advanced nasopharyngeal cancer (NPC) with
neoadjuvant
chemotherapy,
concomitant
chemoradiotherapy (CHRT) adjuvant chemotherapy. We
herein report the results of our experience.
Material and Methods
There were 73 patients with previously untreated stage III
(41,1%), IVa (19,3%) and IVb (38,6%) NPC. The median age
was 52 years. Two cycles of neoadjuvant chemotherapy
consisting of Epirubicin and Cisplatin, 90mg/m2 of each,
were administered followed by CHRT with two same
cycles but at the dose of 60mg/m2 of each drug and once-
daily RT 2Gy/ day (median RTdose was 70GY). Finally,
patients received adjuvant chemotherapy at the same
dose as neoadjuvant approach.
Results
Response to neoadjuvant therapy was 72,6%: complite
response (CR)1,4% and partial responce (PR)71.2%. After
that, 15,5% patiemts had neck dissection. 69 patients
completed CHRT. Response to CHRT was 92%: CR 37,7%
and PR 53,6%, 57 patients received adjuvant
treatment.Therewere 98,2% response, CR 84,2% and PR
14%. The progression' free' survival (PFS) at 3 and 5 years
was 76,5% and 65,3%, respectivaly. Overall survival (OS)
at3 and 5 years was 79% and 67,1%, respectivaly. Median
od PFS and OS not achieved.
Conclusion
Treatment og locoregioally advanced NPC with induction
chemotherapy, CHRT andadjuvant chemotherapy resulted
in very good OS. These results are encouraging. A phase III
study to definitively test this treatment strategy is
warranted.
PO-076 Predictive and prognostic value of pretreatment
fdg-pet suv parameters in head-and-neck