66 / 79
6th ICHNO
page 67
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
__________________________________________________________________________________________
post-chemoHT, whilst 2 patients (stage IVa, IVb)
developed distant metastases 20 and 32 months post-
chemoHT. 3 deaths have occurred at 6 months (stage IVc),
21months (stage IVb), and 31 months (stage IVc) post-
chemoHT. Locoregional control and overall survival at 2
years was 100% and 86% respectively.
At 2 years, reported late side-effects included hearing
problems G2/3 (n=2), neck pain/stiffness G2 (n=2),
vestibular disorder G2 (n=1), trismus G2 (n=1), depression
G1 (n=2), diplopia G2 (n=1), watery painful eye G2 (n=1).
No patients were feeding tube-dependent at 1
year.
Conclusion
Image-guided chemoHT with moderately accelerated
hypofractionation and selective neoadjuvant TPF is
associated with acceptable efficacy and late radiation-
induced toxicities.
PO-140 Long-term outcomes of surgery ± radiotherapy
for salivary gland carcinoma at a single institution
J. Williams
1
1
The Prince of Wales Hospital, Radiation Oncology,
Sydney, Australia
Purpose or Objective
Salivary gland carcinomas are a heterogeneous group of
tumours. Surgery remains the primary treatment modality
of choice, with or without adjuvant radiotherapy (RT) for
high-risk patients. The purpose of this retrospective audit
was to review outcomes of patients treated for salivary
gland carcinomas (SGC) at a single institution based on
prognostic factors, and treatment modality.
Material and Methods
An Ethics approved (HREC11/040) head and neck cancer
database was audited between 1971-2014. Patient
eligibility criteria were: histologically confirmed diagnosis
of primary SGC (newly diagnosed or recurrent), age ≥18
years, definitive treatment with surgery ± RT, or RT-
alone. Primary outcomes were local-control (LC),
ultimate-local control (ULC), cancer-specific survival
(CSS) and overall-survival (OS). Secondary outcomes were
rates of distant metastases. Time to events were
estimated using the Kaplan-Meier method and log rank
test, with P<0.05 considered significant. All analyses were
performed using IBM SPSS version 23.0.
Results
Of the 298 patients with SGC, 161 met the eligibility
criteria (n=145 newly diagnosed, n=16 recurrent). Ninety
patients were male (56%) and median age at presentation
was 63 years (range 21-88). Parotid gland was the most
common location of primary tumour (70%). Twenty-four
patients (15%) were node positive at diagnosis, and 58%
and 29% of tumours were staged T1-2 and T3-4,
respectively, with the remainder not staged or
unknown. Five-year LC, ULC, CSS and OS were 71%, 88%,
72% and 63%, respectively. LC was significantly higher in
patients with T1-2 disease, and ULC was lower in node
positive and high-grade disease (p<0.05). CSS and OS were
higher in patients with T1-2 disease, node negative,
low/intermediate tumour grade and no peri-neural
invasion (PNI). Absence of lympho-vascular invasion (LVI)
was associated with increased OS (p<0.05 for all
variables). Thirty-one patients developed distant
metastases, rates of which were significantly higher in
patients with T3-4 disease, node positive, high tumour
grade, and PNI or LVI (p<0.05 for all variables). Rates of
LC were significantly higher in patients given adjuvant RT
(p<0.01). No other differences by treatment in survival
outcomes were found.
Conclusion
While the addition of RT increased LC, patients with
advanced stage and infiltrative disease continue to have
poor prognoses, with higher rates of local failure, distant
metastases, as well as decreased survival.
PO-141 Adenoid cystic carcinoma of the head and neck:
solid growth pattern as an adverse prognostic factor
J. Fonseca
1
, C. Viveiros
2
, E. Netto
2
, S. Esteves
3
, I.
Fonseca
4
, P. Montalvão
5
, M. Magalhães
5
, F. Santos
2
1
Instituto Português de Oncologia de Lisboa Francisco
Gentil- EPE, Serviço de Radioterapia, Lisboa, Portugal
2
Instituto Português de Oncologia de Lisboa Francisco
Gentil E.P.E., Radiotherapy, Lisbon, Portugal
3
Instituto Português de Oncologia de Lisboa Francisco
Gentil E.P.E., Clinical Investigation Unit, Lisbon,
Portugal
4
Instituto Português de Oncologia de Lisboa Francisco
Gentil E.P.E., Pathology, Lisbon, Portugal
5
Instituto Português de Oncologia de Lisboa Francisco
Gentil E.P.E., Otorhynolaryngology, Lisbon, Portugal
Purpose or Objective
To analyse and report the recent experience of our center
in patients with adenoid cystic carcinoma of the head and
neck (ACC) treated with surgery and radiation therapy
(RT).
Material and Methods
Retrospective and unicentric study of patients diagnosed
with ACC between 2009 and 2014 treated at our
institution. Data were obtained from medical records,
pathology and radiology reports. We evaluated overall
survival (OS), disease free survival (DFS) and locoregional
control (LRC) calculated by the Kaplan-Meier method. Log-
rank test was used for univariate analysis. Toxicity was
recorded according to Common Terminology Criteria for
Adverse Events v4.0 (CTCAE).
Results
Thirty-six patients were identified (53% male; 47%
female). Median age at diagnosis was 63 years (range 18-
81 years). The subsite distribution was oral cavity, 42%
(n=15); paranasal sinuses, 22% (n=8); major salivary
glands, 19% (n=7); nasal cavity, 6% (n=2); other subsites,
11% (n=4). T Stage distribution was T1, 25% (n=9); T2, 22%
(n=8); T3, 25% (n=9); T4a, 17% (n=6); T4b, 11% (n=4).
Seventeen percent of the patients (n=6) had node positive
disease and 6% (n=2) had distant metastases at diagnosis.
The primary treatment was surgery in 33 patients (92%),
while the remaining 3 patients received RT alone.
Pathologically, 88% (n=29) of the patients had R1 margins
(R0, 6%; R2, 6%), 70% (n=23) had perineural invasion (PNI)
and 64% (n=21) had a non-solid growth pattern (solid
growth pattern, 24%; not reported, 12%). Median time
interval between surgery and radiotherapy was 56 days.
Median radiation dose was 66Gy (range 60-72Gy) and it
was delivered using either 3D-CRT (53%) or IMRT (47%).
Nodal irradiation was performed in 8 patients (22%).
Median overall RT treatment time was 48 days (range 39-
61 days). Median follow-up time for surviving patients was
41.7 months (range 17.4-84 months). Fourteen patients
(39%) had disease recurrence. First site of failure was
locoregional in 8 patients, distant in 5 patients and one
patient failed in both sites. Two-year and 3-year OS were
80% and 70%, respectively. Two-year and 3-year DFS were
74%/56% and LRC rates were 89/69%, respectively. On
univariate analysis, solid growth pattern was associated
with worse OS (p<0.001), DFS (p=0.001) and LRC
(p=0.008). Overall RT treatment time superior to 49 days
was associated with worse DFS (p=0.01) and LRC
(p=0.001), whereas PNI showed a trend to significance in
predicting worse DFS (p=0.06). Both patients with distant
disease at diagnosis are alive and have stable M1 disease,
one with local progression. Most frequent reported acute
adverse events were dermatitis and oral mucositis (grades
1-3).