ESTRO 36 Abstract Book

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S584 ESTRO 36 2017
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October 1, 2013 and March 31, 2016. The LE of NPC
patients was obtained using linear extrapolation of a logit-
transformed curve and was adjusted by the corresponding
QOL function to calculate the QALE and SWPS.
Results
The mean age at diagnosis of the 875 non-metastatic NPC
patients was 50.7 years. The median duration from the
beginning of radiotherapy to the date of completing
questionnaires was 6.5 months (range, 0-154.9 months).
The average LE and QALE were estimated to be 15.7 years
and 14.5 quality-adjusted life years (QALYs) for NPC
patients and 29.5 years and 29.5 QALYs for the reference
population, respectively. On average, the lifelong
duration of pain and painkiller use were 5.7 years and 1.8
years. The lifelong duration of any impairment of
swallowing, smell and taste were 14.6 years, 8.5 years and
6.9 years, respectively. The life long duration of dry
mouth was 13.3 years. Furthermore, the lifelong duration
of tube-feeding was only 1.5 months.
Conclusion
This study offers more understandable information than
the 5 year survival outcomes when communicating with
patients or the general population regarding cancer risk
and the impact of treatments on the quality of life. In the
future, evaluating the robustness of comparative
assessments for the outcome of NPC patients undergoing
different treatment protocols will be possible.
EP-1070 Concurrent chemoradiation versus upfront
surgery for clinical T3-4 hypopharynx and larynx
cancer
G.S. Yoo1, D. Oh1 , J.M. Noh 1, Y.C. Ahn1, C.H. Baek2, Y.I.
Son2, H.S. Jeong2 , J.M. Sun3, M.J. Ahn3, K. Park3
1 Samsung Medical Center, Department of Radiation
Oncology, Seoul, Korea Republic of
2 Samsung Medical Center, Department of
Otorhinolaryngology-Head and Neck Surgery, Seoul,
Korea Republic of
3 Samsung Medical Center, Department of Medicine-
Division of Hematology-Oncology, Seoul, Korea Republic
of
Purpose or Objective
The optimal treatment regimen for advanced T stage
hypopharynx and larynx cancer is controversial. In this
study, we aimed to compare the oncologic outcomes and
functional larynx-preservation (FLP) rates for advanced
clinical T stage (T3-4) hypopharynx and larynx cancer
between definitive concurrent chemoradiotherapy (CCRT)
and upfront surgery with or without adjuvant therapy.
Material and Methods
We reviewed the medical records of 148 patients with
clinical T3-4 hypopharynx or larynx cancer who were
treated between January 2005 and May 2013. Primary
treatment was determined in the multidisciplinary team.
In the CCRT group (N=63), 7 (11.1%) patients received
induction chemotherapy, followed by definitive CCRT.
Fifty-five (87.3%) patients were treated with 3-
dimensional conformal radiation therapy (RT), and 8
(12.7%) patients with intensity-modulated RT. The median
RT dose in the CCRT group was 70 Gy (range, 15.4 to 72
Gy). In the surgery group (N=76), TL was performed in 47
patients (61.8%), partial laryngectomy in 28 patients
(36.8%), and partial pharyngectomy only in 1 (1.3%). Fifty-
nine (77.6%) patients received adjuvant RT and 5 (6.6%)
patients received adjuvant CCRT. Median RT dose in the
surgery group was 60 Gy (range, 52 to 70 Gy).
Results
Median follow-up duration was 46 months (range, 0 to 172
months). In total cohort, the 5-year locoregional control
(LRC), progression-free survival (PFS), and overall survival
(OS) rates were 68.7%, 56.5%, and 64.1%, respectively.
Between the CCRT and surgery group, there was
significant difference in LRC rate (CCRT vs. surgery, 57.5%
vs. 78.9% at 5 years, p=0.014). The ultimate LRC rate
including salvage treatment, however, was not different
significantly between the groups (73.2 vs. 81.7% at 5
years, p=0.209). There was no significant difference in
PFS (p=0.175), and OS rates (p=0.965) between the
groups. On the multivariate analysis, treatment modality
was not independent factor for oncologic outcomes.
The 5-year FLP rate was higher significantly in CCRT group
(75.4% vs. 35.5%, p<0.001). The laryngoesophageal
dysfunction-free survival rate in CCRT group was 56.9%.
On the multivariate analysis, treatment modality was
independent factor in FLP with hazard ratio of CCRT group
as 0.261 (95% confidential interval with 0.139-0.488,
p<0.001).
Conclusion
Under the multidisciplinary approach, there were no
significant differences in oncologic outcomes between the
CCRT and surgery groups, while CCRT gave more
opportunity to preserve the laryngeal function.
EP-1071 Organ-sparing SBRT in reirradiation of head
and neck cancer: efficacy, toxicity, and quality of life
I. Zhang1, G. Gill1, M. Marrero1, A. Sharma1, A. Riegel1, D.
Paul2, J. Knisely1, S. Teckie1, M. Ghaly 1
1North Shore LIJ Health System, Radiation Medicine, New
Hyde Park, USA
2North Shore LIJ Health System, Medical Oncology, New
Hyde Park, USA
Purpose or Objective
To present a retrospective analysis of the efficacy,
toxicity, and quality of life (QOL) of patients treated with
organ-at-risk (OAR)-sparing salvage stereotactic body
radiotherapy (SBRT) in previously-irradiated head and
neck cancer.
Material and Methods
From November 2012 to July 2015, 60 patients with in-
field recurrence of head and neck cancer underwent
reirradiation with OAR-sparing SBRT at our institution.
OARs were defined as critical structures that had
approached their radiation tolerances after prior
irradiation and had a high potential to impair QOL if
damaged with re-irradiation. Intact tumors were
prescribed 40 Gy while 35 Gy was prescribed for post-
operative treatments. Doses previously received by the
OARs were estimated by deformably registering the prior
treatment plan onto the new simulation CT to more
accurately delineate dose distributions (Figure 1: Prior
plan overlying the new planning CT without (top) and with
(bottom) deformable registration). Dose constraints for
SBRT were calculated with a biological equivalent dose
(BED) using an alpha/beta ratio of 3 to reduce the risk of