ESTRO 36 Abstract Book

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S575 ESTRO 36 2017
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metastasis. Kaplan-Meier survival analysis revealed TLG (>
vs. < 520), MTV (> vs. < 70), SUVmax (> vs. < 14.0) of
primary tumor, and chemotherapy duration affected
overall survival significantly (P=0.0004, P=0.0059,
P=0.0209, and P=0.0039, respectively). Only TLG
(P=0.0102) and MTV (P=0.0164) were significant factors for
locoregional failure-free survival. In univariate analysis,
chemotherapy duration (P=0.0101), SUVmax of the
primary tumor (P=0.0279), MTV (P=0.0094), and TLG
(P=0.0011) were significant predictors for death; MTV
(P=0.0236) and TLG (P=0.0159) were significant factors in
predicting locoregional recurrence. In multivariate
analysis, both TLG and MTV revealed as an independent
predictor for death (P=0.0057 and P=0.0156) and
locoregional recurrence (P=0.0157 and P=0.0225).
nguage:EN-US; total lesion glycolysis [TLG]).
Conclusion
TLG and MTV were the most important prognostic factors
in predicting mortality and locoregional recurrence in
patients with advanced SCCHN treated by IndCT followed
by surgery/radiotherapy.
EP-1051 Characteristics and Impact of HPV to Head
and Neck Squamous Cell Carcinoma in Thai Patients
C. Jiarpinitnun1, P. Pattaranutaporn1, N.
Larbcharoensub2, T. Chureemas3, J. Juengsamarn3, N.
Trachu 4, S. Lukerak3, P. Chansriwong3, N. Ngamphaiboon3
1 Ramathibodi Hospital, Radiology, Bangkok, Thailand
2 Ramathibodi Hospital, Pathology, Bangkok, Thailand
3 Ramathibodi Hospital, Medicine, Bangkok, Thailand
4 Ramathibodi Hospital, Research center, Bangkok,
Thailand
Purpose or Objective
Head and Neck Squamous Cell Carcinomas (HNSCC) is the
one of common malignancies in Asia. Smoking, alcohol
consumption and betal nut chewing are well-known major
risk factors. Association between human papilloma virus
(HPV) and HNSCC, especially oropharyngeal sites, have
been reported. However, most data reported were from
the Western countries. This study evaluated the
prevalence, the characteristics and the impact of HPV on
the clinical outcomes of treatment in Thai HNSCC patient
Material and Methods
Non-nasopharyngeal HNSCC patients treated at our
hospital between 2007 and 2013 were identified through
the cancer registry database. Basel ine patient
characteristics, treatment data and survivals were
retrospectively reviewed. The formalin-fixed paraffin-
embedded tissue sections were retrieved for p16
analysis. The HPV status was determined by p16
immunohistochemistry, defined by tumor cells
demonstrated nuclear and cytoplasmic staining ≥70%. To
identify the impact of HPV as prognostic factor, the
survival outcomes were analyzed in cases which p16 status
were confirmed.
Results
Total of 205 available FFPE tissues of HNSCC patients was
evaluated for p16 expression. The p16 status was positive
in 24 of 205 cases (11.7%); the positive p16 were found in
men more than women with calculated ratio of 4:1 (20:4
cases). The oropharynx was the most common site found
in p16 positive (34.4%), followed by larynx (11.4%),
hypopharynx (11.1%) and oral cavity (3.2%). The p16
positive was shown in patients who were ever smokers
(77.3%) more than non-smokers (22.7%). Clinical AJCC
stage III-IV was presented in 17 (70.8%) of 24 HNSCC
patients with p16 positive. Baseline patient
characteristics and treatment characteristics were not
statistically different between p16 positive and negative
groups except the site of primary tumor (p<0.001). The 3-
year overall survival was not statistically different but
trended toward p16 positive group (62% vs. 41%, p=0.09).
However, p16 positive HNSCC was significant superior in
3-year disease-free survival (3-yrs DFS 93% vs. 57%,
p=0.01) and in 3-year locoregional free survival (3-yrs LRFS
100% vs. 54%, p=0.007) when compared with p16 negative
HNSCC patients.
Conclusion
In our study, the prevalence of HPV-related HNSCC in Thai
patients was found to be less and the difference in some
characteristics were observed when compared to the
results reported from the Western countries.
Nevertheless, DFS and LRFS were better in p16 status
positive. The trend toward improved overall survival was
also seen. The analyses suggested that p16 status is still a
strong prognostic marker for HNSCC patient in Thailand.
EP-1052 Hypofractionated vs. conventional
radiotherapy for early glottic cancer: a propensity
score analysis
W. Takahashi1, H. Yamashita1, M. Sakuramachi1, T.
Imae1, K. Okuma1, K. Nawa1, K. Nakagawa1
1University of Tokyo, Radiology, Tokyo, Japan
Purpose or Objective
The purpose of this study was to compare the treatment
results and toxicity of hypofractionated radiotherapy
(HRT) with conventionally fractionated radiotherapy
(CRT) for early stage glottic squamous cell carcinoma
(ESGC).
Material and Methods
A single-institutional retrospective study was conducted to
review ESGC patterns of care and treatment outcome.
From February 1998 to January 2016, 204 consecutive
patients with T1-2N0 GSCC were treated in our institution.
Forty-seven patients received HRT and 157 CRT. Using 4
MV photon beam, a median dose of 66 Gy (range, 60–70
Gy) was delivered with daily doses of 2.0 Gy/fraction
(CRT) or 2.4Gy/fraction (HRT). None of the patients
received prophylactic nodal RT. Patients in both
treatment groups were matched using the propensity
score matching method (1:2 ratio). Treatment outcome
was analyzed in terms of local control rate (LCR), distant
failure-free survival (DFFS), progression-free survival
(PFS), overall survival (OS), and treatment-related
adverse events (AE).
Results
The matched cohort consisted of 47 HRT and 94 CRT
patients with the median follow-up of 27 and 62 months,
respectively. Significant higher 5-year LCR and PFS were
observed in the HRT group (96% vs. 82% and 96% vs. 76%,
p=0.031 and 0.015, respectively). No significant
differences in DFFS and OS were observed between
groups. Most acute AE included grade 1-2 mucositis,
dermatitis, dysphagia and/or hoarseness. Except for one
patient who had grade 3 dysphagia in the CRT group, there
was no grade 3 or greater chronic AE.
Conclusion
This large, single-institutional experience of definitive
radiotherapy for ESGC using HRT vs. CRT demonstrates
that HRT achieved high rates of LCR and PFS with minimal
long-term toxicity. Although these results must be