6th ICHNO Abstract Book

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page 66 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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PO-137 Multivariate oral rinse models predict Head and
Neck squamous cell carcinoma (HNSCC)
M. Donovan1, I. Reis2, K. Curtis3, F. Khan1, E. Franzmann4
1Icahn School of Medicine at Mt. Sinai, Pathology, New
York City, USA
2University of Miami, Public Health Sciences and Division
of Biostatistics, Miami, USA
3Vigilant Biosciences, Clinical, Ft. Lauderdale, USA
4University of Miami, Otolaryngology, Miami, USA
Purpose or Objective
Background: Head and neck squamous cell carcinoma
(HNSCC) is the 6th most common cause of cancer mortality
throughout the world affecting some 50,000 people in the
US and 600,000 worldwide each year. The ability to detect
the disease in a potentially malignant phase and earlier
stage could have significant impact on overall outcome.
Previous studies have demonstrated that a combined
salivary CD44, a tumor-initiating marker, and total protein
assay was able to aid in the diagnosis of HNSCC. We sought
to better understand the cut-point performance
characteristics of these biomarkers in an expanded
training cohort.
Material and Methods
Methods: Oral rinse specimens from 310 patients (107
HNSCC cases; 203 controls) were obtained from
biorepositories. A training cohort was generated, divided
equally and demographically balanced. Levels of CD44 and
total protein (TP), +/- clinical variables were evaluated
using the AUC, sensitivity, specificity; support vector
machine (SVM) multivariate models were also generated.
Results
Results: 95% HNSCC patients (cases) were >/=40 years of
age, 72% male, 97% white and 65% smokers vs. 23%, 36%,
60% and 44% respectively, for controls. Predicted cut-
points for CD44 and TP yielded an AUC of 0.72 for
discriminating cancers. A logistic regression model which
included continuous levels of CD44 and TP combined with
sex, and race produced an of AUC 0.83; while an SVM
model which incorporated age, sex, race, smoking history
with continuous CD44 and TP yielded a sensitivity of 87%
and a specificity of 94%.
Conclusion
Conclusions: Elevated and combined levels of both CD44
and TP continue to perform well for discriminating HNSCC
from control patients. The incorporation of clinical factors
including smoking status, sex and race appears to improve
overall performance of the assay. Additional validation
studies are underway to further confirm these results.
Poster: Salivary gland, skull base, skin and thyroid
cancers
PO-138 IMRT of sino-nasal cancer: improved results
compared to 3D radiotherapy.
T. Frédéric-Moreau1, L. Piram 1, J. Miroir1, N. Saroul2, C.
Millardet 3, F. Kiakowski4, M. Lapeyre1, J. Biau1
1Centre Jean Perrin, Radiotherapy, Clermont Ferrand,
France
2CHU Gabriel Montpied, Otorhinolaryngology Surgery,
Clermont Ferrand, France
3Centre Jean Perrin, Medical Physics, Clermont Ferrand,
France
4Centre Jean Perrin, Biostatistics, Clermont Ferrand,
France
Purpose or Objective
Prospective evaluation of the results of intensity-
modulated radiation therapy (IMRT) in sino-nasal cancer
compared to a historical series of patients (pts) treated
with three-dimensional conformal radiotherapy (RT3D).
Material and Methods
Between 2011 and 2015, 42 pts were treated with IMRT
and integrated boost (Rapidarc®). Doses in low-risk,
intermediate and high volumes were 54, 60 and 66-70 Gy
respectively. They were retrospectively compared with a
historical series of 30 pts treated with RT3D (50 to 66Gy),
from 2007 to 2011. There were 28 ethmoid, 27 maxillary
sinuses and 17 nasal cavities. There were 34 squamous cell
carcinomas, 27 adenocarcinomas and 4 other histological
types. There was no significant difference between the 2
groups (histology, location, stage and surgery).
The efficacy and toxicity results were evaluated.
Results
Median follow-up was 30 months (range, 1.4-112 months).
Two-year local control was 81% in IMRT vs 57% in RT3D
(p=0,05). In multivariate analysis, the prescribed dose at
high risk volume was predictive of local control regardless
technique (p=0,05). Two-year overall survival was 92% in
IMRT vs 55.5% in RT3D (p = 0.002). In IMRT, ocular acute
toxicity rate of grades 1, 2 and 3 were 48%, 28% and 0%
respectively. Mucosa, skin and salivary acute toxicity rate
of grade ≥ 3 were 14%, 2% and 0% respectively. At one
year, ocular toxicity rate of grades 1, 2 and 3 were 36%,
18% and 0%.
Conclusion
IMRT significantly improves local control and overall
survival in sino-nasal cancer allowing to bring a higher
dose to the target volume. Acute and late toxicities
remain low.
PO-139 Hypofractionated accelerated chemo-
Tomotherapy for nasopharyngeal cancer: 2-year
treatment outcomes
C.T.K. Fong1, C.S. Boon1, P. Sanghera1, A. Hartley1
1Queen Elizabeth Hospital, Hall-Edwards Radiotherapy
Research Group, Birmingham, United Kingdom
Purpose or Objective
To report outcomes for nasopharyngeal carcinoma (NPC)
patients treated with selective neoadjuvant docetaxel,
cisplatin and 5FU (TPF) chemotherapy and IMRT delivered
by helical TomoTherapy® (HT) using a hypofractionated
accelerated schedule plus concurrent platinum in a UK
institution.
Material and Methods
Since December 2011, patients with NPC receiving
chemoradiotherapy were treated using HT. Three dose
levels were used: 65Gy/30 fractions to GTV; 60Gy/30
fractions to high-risk local site plus retropharyngeal
nodes; 54Gy/30 fractions to uninvolved bilateral nodal
levels Ib, II, III, IV, V, VIIb. All patients received concurrent
platinum chemotherapy. Patients with T≥3 or N≥1 or M1
also received neoadjuvant TPF. Data collected included
locoregional control, survival and late radiation toxicity
using CTCAE v4.
Results
19 patients met the inclusion criteria (median age 46
years, range 19-68). WHO histology: keratinising squamous
= 4; non-keratinising = 14 (undifferentiated = 11,
differentiated= 3); basaloid squamous = 1. TNM-7 staging
was: I =3; II =3; III =4; IVa =4; IVb =2; IVc =3. Fourteen
patients received neoadjuvant TPF (median 3 cycles,
range 1-5). All patients completed the prescribed
radiation dose with median overall treatment time of 39
days (range 37-45). Concurrent chemotherapy used were
cisplatin (n=15) or carboplatin (n=4).
At a median follow-up of 31 months (range 13–52) post-
chemoHT, none of the 19 patients have developed
locoregional relapse. 2 patients with stage IVc disease
developed further distant metastases at 3 and 6 months