ESTRO 36 Abstract Book

592 / 1082

S576 ESTRO 36 2017
_______________________________________________________________________________________________
confirmation by randomized controlled study, HRT should
be considered for the treatment of ESGC.
EP-1053 Analysis of outcomes of Adenoid cystic
Carcinoma of Head and Neck region: Single Institution
Study
M. Rafi1, M. Anjanappa1, C. Kainickal1, P. George 2, R.
Kumar1, R. Kunnambath1
1 Regional Cancer Centre, Radiation Oncology,
Trivandrum, India
2 Regional Cancer Centre, Epidemiology and biostatistics,
Trivandrum, India
Purpose or Objective
To study the treatment outcomes of Adenoid cystic
carcinoma of the head and neck region.
Material and Methods
The case records of patients who were diagnosed and
treated for adenoid cystic carcinoma of head and neck
region in a tertiary care hospital in India between 2004
and 2011 were retrospectively reviewed. Demographic
data, clinico-pathological details and treatment outcomes
were captured using a structured proforma, for survival
analysis and identification of prognostic factors.
Results
A total of 164 patients reported to the institution with
biopsy proven adenoid cystic carcinoma of the head and
neck region during this period. Out of this, 142 patients
were included in the analysis after excluding the patients
who did not undergo any treatment at this centre.
Out of the 142 patients analyzed, 57.7% were females. The
mean age of presentation was 46.5yrs (Range 16-84 yrs).
The most common site of presentation was oral cavity
(28.2%) followed by paranasal sinus and nasal cavity
(22.5%), and parotid gland (15.5%). A total of 44.4% of
patients had stage I /II disease. Node positivity was seen
in 16 patients (11.2%) and three patients had metastatic
disease at presentation.
Surgery was the primary modality of management in 120
patients(84.5%).Among them 67 patients (47.2%) had
margin positive resection. Most of these were either
unplanned excisions or were paranasal sinus lesions.
Radiotherapy was delivered to 120 patients (84.5%) as a
part of their treatment, with majority being given
adjuvant radiotherapy (100 patients). Curative
radiotherapy was used in 18 patients. Radiotherapy dose
ranged from 60-70 Gy in two Gy equivalent.
Recurrence was recorded in 47 patients (33%); 21 patients
had isolated recurrence in the primary site, 20 had
systemic failure, 5 patients had nodal failure and 1 patient
had systemic and local failure. The mean time for
development of failure was 32 months (Range 1-99months)
for systemic and 44.5 months (Range 5-105months) for
loco-regional site. Of the 18 patients who were given
radical RT, 14 had complete response (77.7%) and among
them eight patients had disease recurrence.
Radiotherapy was given to 13 patients with recurrence,
eight patients underwent surgery, three patients had
chemotherapy and 11 patients were just kept on follow-
up.
The disease free survival at 5 years was 76.9%.
Conclusion
Adenoid cystic carcinomas are relatively rare neoplasms
of salivary glands. A good proportion of these tumours
occur in minor salivary glands as reflected in this analysis.
Surgery remains the preferred primary treatment modality
with a large proportion of patients also getting RT as a
part of their treatment. Along with loco-regional failure,
these tumours also have a propensity for distant
metastasis.
EP-1054 Disease Outcomes following Post-operative
IMRT for Oral Cavity Cancer: A Single Institution
Analysis
A. Michaelidou1, M. Lei1, T. Guerrero Urbano1
1Guy's & St Thomas' NHS Foundation Trust, Oncology- 4th
Floor Bermondsey Wing, London, United Kingdom
Purpose or Objective
The purpose of this study is to analyse survival outcomes
in patients with oral cavity squamous cell carcinoma
(OCSCC) treated with radical surgery and post-operative
IMRT (POIMRT), +/- chemotherapy, at our institution.
Material and Methods
A retrospective analysis was performed of all patients with
OCSCC who received IMRT with radical intent between
March 2010 and March 2016. Data were extracted from
electronic case records, reviewed only by members of the
responsible clinical team. Statistical analysis was done
using IBM SPSS and Microsoft Excel. Estimates of overall
survival (OS), disease-free survival (DFS) and disease
specific survival (DSS) were done using life tables and the
Kaplan-Meier method.
Results
138 patients with OCSCC received IMRT in total. 127 (73-
male, 54-female; mean age-62, range 26-86) were
included in the survival analysis. 9 patients unsuitable for
surgery that had primary IMRT alone, and one patient who
died of aspiration during treatment were excluded. Of the
127 patients analysed, 7 did not complete the prescribed
course of POIMRT (patient choice in 3, clinician decision
because of toxicity in 4).
Most patients had advanced disease on pathological
staging: AJCC stage IV - 77.2%, n=98; stage III – 15.7%,
n=20; Stage II – 2.4%, n=3; Stage I - 4.7%, n=6. Smoking
history was recorded in 124 patients: 64.5%, n=80 reported
a significant smoking history (smoking at diagnosis or ex-
smokers with >10 pack years).
Standard POIMRT doses were 60Gy in 30# (64.6%, n=82)
and 65-70Gy in 30-33# (24.4%, n=31) for those with
involved margins. Doses of 50-55Gy in 20# were used in
those with significant co-morbidities or a poor
performance status (11.0%, n=14). Concurrent
chemotherapy with cisplatin100mg/m2 or carboplatin
AUC5 (when cisplatin contra-indicated), 3-4weekly, was
considered in patients with extracapsular spread and/or
involved margin (49.6% n=63) and given to those with no
contra-indications (31.5%, n=40).
Median follow up from the end of treatment was 20.7
months (range 0.9-76.8 months) in all patients. Median
follow in survivors was 30.9 months (range 7.3-76.8
months). At the time of analysis 39 patients had a
confirmed relapse and 52 patients had died (35 disease
related). Mean survival rates were: OS 45.9 months (95%
CI 39.8-52.1); DFS 43.5 months (95%CI 37.5-49.5); DSS 55.4
months (95% CI 49.4-61.3).
One-year survival rates were: OS 74% (95%CI - 66.2 – 81.8);
DFS 74% (95%CI – 66.2 – 81.8); DSS 79% (95%CI – 71.2 – 86.8).
Three-year survival rates were: OS 54% (95%CI - 44.2 –
63.8); DFS 51% (95%CI – 41.2 – 60.8); DSS 66% (95%CI – 56.2
– 75.8).
Conclusion
Our results are consistent with nationally reported survival
data. Ongoing work is carried out to report treatment
related toxicities and identify histopathological factors
that may influence prognosis.
EP-1055 A Novel Postoperative Chemoradiotherapy
Protocol versus Conventional CCRT for High-risk SCCHN
Y.T. Shih1, W.Y. Wang2, C.T. Wu3, J.C. Lin 4
1St. Martin De Porres Hospital, Radiation Oncology
Department, Chiayi, Taiwan
2Hung Kuang University, Department of Nursing,
Taichung, Taiwan
3Changhua Show Chwan Memorial Hospital, Department
of Radiation Oncology-, Changhua, Taiwan
4Taichung Veterans General Hospital, Department of
Radiation Oncology-, Taichung, Taiwan