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6th ICHNO
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
__________________________________________________________________________________________
Conclusion
In our study, surgery and radiation therapy produced
excellent locoregional control similar to the published
literature. Solid growth pattern was associated with worse
OS, DFS and LRC. Our study also shows the impact of
overall treatment time in DFS and LRC. Longer follow-up
is encouraged to better understand the natural history of
this carcinoma.
PO-142 A 10-year review of primary major salivary
glands carcinomas
H. Magalhães
1
, F. Pereira
1
, C. Vieira
1
, A. Isabel
1
, M.
Jácome
2
, J. Dinis
1
1
Instituto Português de Oncologia do Porto Francisco
Gentil- EPE, Medical Oncology, Porto, Portugal
2
Instituto Português de Oncologia do Porto Francisco
Gentil- EPE, Pathology, Porto, Portugal
Purpose or Objective
Primary salivary gland malignancies, which comprise a
diverse group of histological entities, represent less than
5% of all new head and neck cancers. Currently, surgical
resection remains the standard of care, with adjuvant
radiotherapy performed in selected cases. Chemotherapy
can be used in metastatic or recurrent setting, but has
limited effect.
Our objective was to review a 10-year experience of a
single institution on major salivary glands carcinomas,
aiming on demographics, treatment and outcomes.
Material and Methods
A pathology database of salivary glands tumours was
reviewed for all cases of a single institution from January
1995 until July 2016. Then we selected all the patients
with histopathological diagnose of primary major salivary
gland carcinoma from March 2006 to July 2016.
Results
A total of 933 patients were identified, with 33% of them
with malignant histology. After excluding patients with
metastasis from other sites, we identified, in the last 10
years, 93 patients with primary major salivary gland
carcinoma.
In this sample of patients, the median age at diagnosis was
63.1 years (age range 17-90 years), and 51% (n= 48) were
male. The majority of the primary tumours were from the
parotid gland, representing 76% of all cases. Salivary duct
carcinoma was the most frequent histological type
(21,5%), followed by adenoid cystic carcinoma (16,1%) and
mucoepidermoid carcinoma (13,9%). About 25% of patients
had recurrent disease, with 41,6% (n=10) of patients with
salivary duct carcinoma; median time to recurrence was
21.52 months. The 5-year survival was 90.2% for stage I;
85.2% for stage II; 66.6% for stage III; and 6.4% for stage
IV. Median overall survival for stage IV was 30 months (95%
confidence interval 19.67- 40.32). Only 5 patients
received palliative chemotherapy based on doxorubicin
and platinum agent.
Conclusion
Our analysis of this retrospective cohort is in accordance
with the literature in respect of median age at diagnosis,
gender predominance and outcomes, with the exception
in terms of most frequent histological type in our series,
the salivary duct carcinoma (estimated to represent only
1-3% of the salivary tumours), probably because our
institution is a high-specialized oncology center.
Patients with advanced disease have worse survival, and
only few patients were treated with palliative
chemotherapy, making it difficult to draw conclusions.
PO-143 Salivary gland tumours: preliminary results of
the Trento Protontherapy Centre
I. Giacomelli
1
, D. Scartoni
1
, M. Cianchetti
1
, F. Dionisi
1
, S.
Lemoine
1
, M. Amichetti
1
1
APSS Trento, U.O. Protonterapia, Trento, Italy
Purpose or Objective
To report the initial experience in treating salivary gland
tumors with protontherapy (PT)
Material and Methods
Between October 2014 and October 2016, 20 patients (pts)
(10 M, 10 F) have been treated with PT. Median age at PT
was 58.5 years (range,23-90). Median KPS was 90 (80-100).
Stage was II: 2; III: 3, IVa: 11; IVb: 2; IVc: 1 and 1 benign
pleomorphic adenoma. Parotid gland was involved in 8
cases, submandibular in 3. Minor sites were: maxillary
sinus 6; hard palate 1; nasopharynx1; skull base 1.
Pathology was: 10 adenoid cystic carcinoma, 6
mucoepidermoid carcinoma, 1 SCC, 1 adenocarcinoma ex
pleomorphic adenoma, 1 pleomorphic adenoma, 1 other.
Eight pts received one surgical resection, 5 pts 2
resections, 4 pts 3 resections. Three pts had biopsy only.
Eleven pts were treated at their initial disease course, 7
in adjuvant setting (1 R0; 4 R1; 2 R2), 3 with definitive
intent, one palliative. Nine pts were treated for recurrent
disease, 5 with adjuvant intent (1 R0, 4 R1), 3 with radical
intent, 1 palliative. Re-irradiation (Re-RT) was performed
in 4 cases. Acute and late toxicities have been reported
according to CTCAE scale version 4.0.
Results
Median follow-up was 6.1 months (range, 0-12.4). All pts
but one completed their treatment without any break due
to acute toxicity. Withdrawal from PT was for patient’s
personal conviction. PT was delivered in all cases with
single field optimization-active scanning technique.
Median definitive total dose was 69.3 Gy(RBE) (range, 60-
70 Gy(RBE), median adjuvant dose 66 Gy(RBE) (range, 60-
70.4 Gy(RBE). Pts receiving Re-RT had been previously
irradiated at a median dose of 60Gy (range, 60-70 Gy). PT
Re-RT median dose was 66 Gy(RBE) (range 60-70 Gy(RBE).
In one case PT was given as the third RT course, to a
radical dose of 70 Gy(RBE). No acute toxicity > grade 3 was
observed. Grade 3 acute cutaneous toxicity was seen in 4
pts. Oral and sinonasal mucositis of grade 3 occurred in 2
pts. Other acute toxicities < grade 3 are listed in the table
below. One diabetic patient experienced surgical wound
dehiscence one month after PT completion. Cutaneous G1
late toxicity was seen in 3 pts, grade 2 in one pt, 2 patients
developed oedema and fibrosis of the subcutaneous
tissues and 1 pt cutaneous telangiectasia G1. Two cases of
trismus G1 and one case G2. Two pts had necrosis of
irradiated mucosa but it was limited to a little area in both
cases. At the time of the analysis, 13 pts are free of
disease, 4 pts have stable disease, 2 pts in local control
developed distant metastasis, one pt (treated with
palliative intent) died for local recurrence and distant
metastases.
Acute Toxicity
Tot. pts
G1
G2
G3
Cutaneous
16
1 11 4
Mucositis
12
6 4 2
Wound dehiscence
1
1
Xerostomia
3
3
Fatigue
2
1 1
Conjunctivitis
5
4 1
Otitis
5
2 3
Alopecia
4
4
Dysgeusia
2
1 1
Conclusion