ESTRO 36 Abstract Book

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S580 ESTRO 36 2017
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Fig. 1: Web-based decision aid tool for advanced larynx
cancer patients
Conclusion
A systematic validation process, as IPDAS, makes it
possible to understand the characteristics and decisional
needs of patients and clinicians, which are specific and
differ among diseases and contexts. This is essential for
implementation of PDAs in the clinical practice.
EP-1062 Hypofractionated vs standard radical
radiotherapy in early (T1-T2) glottic cancer patients.
M.A. González Ruiz1, J.J. Cabrera Rodríguez1, A. Ruiz
Herrero1, M.C. Cruz Muñoz1, P. Simón Silva1, J. Quirós
Rivero1, J.L. Muñoz García1, Y. Ríos Kavadoy1, M.F.
Ropero Carmona1, F. García Urra1
1 Infanta Cristina Hospital, Radiation Oncology, Badajoz,
Spain
Purpose or Objective
To analyze the results [(disease free survival (DFS) and
overall survival (OS)] of patients (pts) with glottic cancer
(GC) treated with hypofractionated radiation therapy
versus standard radiotherapy treatment with radical
intention.
Material and Methods
Retrospective comparative study of 125 pts with GC T1 or
T0is stage (119 pts) and T2 stage (6 pts) treated with
radical intention with radiation therapy in our hospital
from June 1995 to June 2015. Hypofractionated treatment
(2,25 Gy/fraction; total dose 63 Gy) was used in 42 pts and
standard treatment (2 Gy/fraction; total dose 70 Gy) was
used in 83 pts. Baseline characteristic were similar in both
groups. Median total dose of radiotherapy was 66 Gy
(range 63-70). Kaplan-Meier curves have been used for the
statistical analysis of survival and the log-rank test for the
comparison of the survivals. Treatment-related toxicity
was assessed using RTOG and the NCI-Common
Terminology Criteria for Adverse Events guidelines.
Results
The median follow-up was 215 months. The DFS and OS in
hypofractionated group were 97,6% and 93% respectively
and in standard radiotherapy group were 93% and 95,2%
respectively without statistically significant differences.
When we analyzed OS by stage subgroups, we can see that
in T1 or T0is group the results are better (95,8%) than in
T2 group 66,7% (p 0,001) without differences because of
the treatment regimen used. In the analysis according to
the age of the pts, we had the following results in terms
of OS: < 70 years-old pts treated with hypofractionated
treatment (28 pts) were 96,4 % and >70 years-old pts (14
pts) were 100%. The OS in < 70 years-old pts treated with
standard treatment (43 pts) was 93% and in >70 years-old
pts (40 pts) was 92,5% without statistically significant
differences. When we analyze OS according to the anterior
commissure involvement, we haven´t found statistically
significant differences. In both groups the majority of pts
had acute skin and mucosa toxicity grade 1-2 without
statistically significant differences regardless the regimen
of treatment used.
Conclusion
Hypofractionated treatment supposed better local disease
control than standard treatment but in terms of OS there
weren´t any differences. When we analized our pts by
subgroups stage, we found that T2 stage group had worse
results than T1 or T0is stage group in terms of OS (p 0,001)
regardless of treatment used. There weren´t no
differences in terms of toxicity nor local control between
elderly pts and young pts regardless of treatment used
either.
EP-1063 Epidemiology and clinical outcome of HPV in
different head and neck cancer a subgroup analysis
E. Boelke1, B. Gössler1, B. Tamaskovic 1, W. Budach 1, C.
Matuschek1
1University Hospital Düsseldorf Heinrich Heine University
Düsseldorf, Radiation Oncology, Düsseldorf, Germany
Purpose or Objective
Human papillomavirus (HPV)-associated squamous cell
carcinoma of the oropharynx is a well-defined disease
typically affecting young to middle-aged male non-
smokers. The incidence of HPV-associated oropharyngeal
cancers is rapidly increasing in most Western countries,
but detailed epidemiological data are not available for the
Dusseldorf population. Moreover, among other head and
neck regions, a less significant proportion of oral high-
grade dysplasia and cancers appears to depend on HPV
infection, whereas its role in laryngeal cancer is
recognized as less significant. The aim of this study was to
find out the incidence and clinical outcome of HPV
infection in different head neck cancer patients in a
German population.
Material and Methods
In this retrospective study, the tumour tissue from 164
patients (110 men, 54 women, 62.8 years + 12.7) with
head neck cancer (oropharynx = 65 nasopharynx = 10,
larynx = 13, hypopharynx = 15, oral cavity = 33 CUP = 5,
Other = 23) were tested for HPV infection. Furthermore,
the clinical outcome for all tumor sides was examined with
uni and multivariate analysis. We analyzed p16 in all
tumor tissues as a surrogate marker for HPV infection with
immunohistochemistry. Moreover, risk factors such as
nicotine, alcohol abuse, location of the tumour, resection
margin of the tumour tissue, histology, lymph nodes
involvement, extracapsular spread, tumour stage, and the
treatment of the tumour (surgery, chemo and radiation
therapy) were examined for local tumour control and
overall survival for all patients.
Results
The prevalence of HPV infection in oropharynx-carcinoma
patients in Dusseldorf was 33%. Patients with HPV-positive
oropharyngeal carcinomas showed a tendency towards
longer survival time, (p = 0.76, HR: 2.42, 95% CI 0.91 -
6.44) compared to HPV-negative tumours. This association
was independent from alcohol and nicotine abuse. Other
tumour locations like larynx or hypopharynx carcinoma
showed no association between HPV infection and clinical
outcome. As expected the tumour stage in all tumour
locations was significant in the uni and multivariate
analysis for local control and overall survival.
Conclusion
The HPV infection in Dusseldorf was lower than
anticipated. Furthermore, in our study it seems that p 16
positive oropharyngeal carcinoma patients have a better
clinical outcome than p 16 negative patients. In this
patient group p 16 can be used as a prognostic biomarker.
This was independent from alcohol and nicotine abuse.
But for other tumor localizations we could not find a
better clinical outcome.
EP-1064 Does parotid sparing adaptive radiotherapy
(PSART) benefit patients? Interim results of PARITY
study
M. Arunsingh 1, C. Nallathambi 1, S. Prasath1, A.
Balakrishnan1, R.K. Shrimali1, R. Achari1, I. Mallick1, S.
Chatterjee1
1Tata Medical Center, Department of Radiation
Oncology, Kolkata, India