6th ICHNO Abstract Book

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page 38 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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that PTV margins can be safely reduced if daily CBCT is
possible.
PO-079 Hypofractionated versus prolonged chemo-IMRT
schedules in oropharyngeal carcinoma
I. Boon1 , C. Boon1,2, P. Nightingale3, J. Cashmore1, G.
Sangha1 , M. Hickman1, H. Benghiat1, C. Fong 1, P.
Sanghera1,2 , A. Hartley1,2
1Hall-Edwards Radiotherapy Research Group, Queen
Elizabeth Hospital, Birmingham, United Kingdom
2Institute of Head and Neck Studies and Education
InHANSE, University of Birmingham, Birmingham, United
Kingdom
3Wolfson Computer Laboratory, Queen Elizabeth
Hospital, Birmingham, United Kingdom
Purpose or Objective
Hypofractionated radical radiotherapy is gaining
acceptance with proven non-inferiority demonstrated in
breast and prostate cancer. Rotational IMRT with daily
image guidance has increased confidence in the safe
delivery of hypofractionated treatment. The purpose of
this study was to compare efficacy outcomes at a
minimum follow up of 2 years in two historic cohorts of
locally advanced oropharyngeal carcinoma patients
treated with 4-week (20#) or 5-7 week (25-35#) schedule
in a single institution.
Material and Methods
Between June 2009 and May 2012 (4 week cohort),
patients undergoing chemoIMRT were treated with
55Gy/20# over 25 days, with synchronous
carboplatin. From June 2012 to April 2014 (>4 week
cohort), similar patients were treated with either (a)
64Gy/25# over 32 days, (b) 65Gy/30# over 39 days, or (c)
70Gy/35# over 46 days, with synchronous cisplatin or
carboplatin. Patients treated with synchronous cetuximab
were excluded from this study. Overall survival, local
control, distant control, and freedom from recurrence at
2 years were calculated for these cohorts. The effect of
the following variables on outcome was analysed: age, T-
stage, N-stage, p16 status, smoking status, chemotherapy
agent (cisplatin/carboplatin), use of neoadjuvant
chemotherapy, and radiotherapy schedule (4-week vs. >4
week).
Results
131 patients with non-metastatic oropharyngeal
carcinoma received radical IMRT with concurrent platinum
(4-week, n=70; >4 week, n=61). There were significantly
more smokers with >10 pack year history (p<0.001) and
less patients who received neoadjuvant chemotherapy in
the >4 week cohort (p=0.001). Conversely more patients
received cisplatin synchronously in this cohort (p<0.001).
There were no other significant differences in baseline
characteristics. T stage was found to have a
statistically significant effect on overall survival (p=0.02)
and local control (p=0.04). p16 status was statistically
significantly associated with overall survival (p=0.002).
None of the other variables evaluated had a statistically
significant impact on the endpoints considered. At 2 years,
local control (p=0.256), freedom from recurrence
(p=0.192), and overall survival (p=0.511) were not
statistically different between the 4-week and >4 week
cohorts.
Conclusion
Survival and disease control were comparable in
oropharyngeal carcinoma patients treated with 4-week or
>4 week hypofractionation schedules. However, due to
obvious confounding factors in this retrospective study;
accelerated hypofractionated schedules for radical
chemoIMRT in oropharyngeal carcinoma need prospective
evaluation to determine whether such potentially
resource sparing regimes truly offer equivalence in
efficacy and quality of life.
PO-080 Challenges and opportunities in head and neck
cancer research in the UK: a survey of oncologists
B. Foran1, J. Fenwick2, B. Byrne 2, J. Christian 3
1Weston Park Hospital, Oncology, Sheffield, United
Kingdom
2Merck Serono Ltd- UK- an affiliate of Merck KGaA-
Darmstadt- Germany, Medical Affairs, Feltham, United
Kingdom
3Nottingham City Hospital, Oncology, Nottingham,
United Kingdom
Purpose or Objective
Research into head and neck cancer (H&NC) management
is vital for the development of new treatment options and
improving patient outcomes; recent evidence (Wuthrick et
al, 2015) suggests that outcomes are better when patients
are treated at centres with high levels of participation in
H&NC clinical trials. We conducted a survey of H&N cancer
clinicians from oncology departments in the UK and
Ireland to gain insights into their experiences of H&NC
research.
Material and Methods
During March 2016, 55 H&N cancer clinicians from centres
across the UK and Ireland were invited to complete an e-
mail survey about their level of participation in H&NC
research, the current challenges and priorities for future
research. Here we present the responses of 45 consultants
(43 clinical oncologists and 2 surgeons) from National
Health Service centres in the UK (excluding Ireland).
Results
When asked to estimate the amount of Supporting
Professional Activities (SPA) time in their weekly job plan
for H&NC research, 37% of respondents (13/35 for whom
the question was relevant) answered that they had no
allocated time. Among the remaining 22 respondents, the
median estimated SPA time was 1.25 hours per week
(range 0.25-15) ( figure 1). 16% of respondents (7/45) are
not currently recruiting to a major national clinical trial
(De-ESCALaTE, PATHOS, NIMRAD, CompARE, HOPON or
DAHANCA 21), 52% (23/44) are not recruiting to any
local/non-portfolio trials and 58% (25/43) are not aware
of the trials that are open in other centres. The most
frequently identified constraints in H&NC research were
lack of clinician time and service pressures (80%, 36/45);
lack of resources, staff or infrastructure to support and
run trials (71%, 32/45); lack of interest (16%, 7/45);
patient factors including the relative rarity of H&NC, co-
morbidities and poor performance status (13%, 6/45); lack
of funding/budget (13%, 6/45) and a lack of H&NC trials
(13%, 6/45). A wide variety of priorities and potential
questions for future H&NC research were identified.