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ESTRO 36 2017
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Electronic Poster: Clinical track: Head and Neck
EP-1026 Clinical Outcomes of Taiwan cT4b OSCC:
Toward the Identification of the Optimal Initial
Treatment
T.C. Yen
1
, C.T. Liao
2
, Y.W. Wen
3
, L.Y. Lee
4
, C.Y. Lin
5
,
H.M. Wang
6
, C.H. Lin
7
1
Chang Gung Memorial Hospital, Nuclear Medicine,
Taoyuan, Taiwan
2
Chang Gung Memorial Hospital, Otorhinolaryngology-
Head and Neck Surgery, Taoyuan, Taiwan
3
Chang Gung University, Clinical Informatics and Medical
Statistics Research Center, Taoyuan, Taiwan
4
Chang Gung Memorial Hospital, Pathology, Taoyuan,
Taiwan
5
Chang Gung Memorial Hospital, Radiation Oncology,
Taoyuan, Taiwan
6
Chang Gung Memorial Hospital, Medical Oncology,
Taoyuan, Taiwan
7
Chang Gung Memorial Hospital, Plastic and
Reconstructive Surgery, Taoyuan, Taiwan
Purpose or Objective
The NCCN guidelines recommend that patients with oral
cavity squamous cell carcinoma (OSCC) and cT4b disease
should be either included in clinical trials or treated with
a non-surgical approach. However, surgery may be
feasible in selected patients with adequate safety
margins. Using the nationwide Taiwanese Cancer Registry
Database, we examined the prognosis of cT4b OSCC
patients in relation to their treatment approach.
Material and Methods
Of the 18,910 patients with previously untreated first
primary OSCC identified between 2004 and 2010, 492
(2.6%) had cT4b tumors. Of them, 327 (66%) received
initial treatment with surgery, whereas 165 (34%) were
initially treated with a non-surgical approach. Of the
latter group, 78 patients subsequently underwent surgery.
A 5-year disease-specific survival (DSS) ≥45% was
considered as a favorable outcome.
Results
Better 5-year DSS and overall survival (OS) rates were
observed in cT4b patients initially treated with surgery
(versus non-surgery; DSS, 51% versus 38%; OS, 43% versus
27%, respectively, p <0.001). Of the participants initially
treated with surgery, patients with cN0-2 disease had
better 5-year survival rates (DSS: cN0, 59%; cN1, 53%; cN2,
46%; OS: cN0, 49%; cN1, 50%; cN2, 37%) than those with
cN3 disease (DSS: 0%; OS: 0%). Among cT4b patients who
initially received a non-surgical treatment, subjects who
subsequently underwent surgery showed better outcomes.
Conclusion
Primary surgery is performed in approximately two-thirds
of cT4b OSCC patients, with cN0-2 cases showing a good
prognosis. Patients who initially received a non-surgical
approach can subsequently be treated with surgery and
achieve favorable
outcomes.
EP-1027 Evaluation of induction chemotherapy
followed by radiation therapy in advanced
oropharyngeal cancers
R.K. Pothamsetty
1
, B.P. THALIATH
1
, R.R. GHOSH
1
1
Kamala Nehru Memorial Hospital, Radiation Oncology,
Allahabad, India
Purpose or Objective
1. Evaluation of acute and late radiation morbidity using
the
RTOG criteria in
both
arms.
2. Evaluation of loco-regional failures, diffuse free
survival and overall survival in both arms.
Material and Methods
The study design was a prospective, comparative,
randomized double arm study involving patients of all age
groups of both the sexes, Stage III and Stage IVA
oropharyngeal cancer who were biopsy
proven squamous cell carcinoma reported to Kamala
Nehru Memorial Hospital, Allahabad from February 2014-
June 2015. They were subjected to induction
chemotherapy as scheduled. Complete and
partial responders were randomized into 2 arms: Arm A
(Conventional external beam radiotherapy) and Arm B
(Intensity modulated radiotherapy). Both the groups