ESTRO 36 Abstract Book

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S592 ESTRO 36 2017
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we reviewed medical records of 71 patients with locally
advanced laryngeal cancer (T3-4 or N+) treated at the
Radiation Oncology Department, National Cancer
Institute, Cairo University, Egypt, during the period from
2007 to 2013 inclusively. Prognostic factors, treatment
modalities, and their effect on loco-regional control (LRC)
and overall survival (OS) were studied.
Results
mean age was 61 years. Smoking history was present in
94% of patients. Squamous cell carcinoma was the most
common pathological type (98%). Glottic carcinoma
represent 31%, supraglottic carcinoma represent 60.5%,
while transglottic carcinomas represent 8.5% of patients.
Prescribed radiotherapy dose was 70Gy/35 fractions/7
weeks. Combined chemoradiotherpy was used in 72%,
while radiotherapy alone was used in 28% of patients.
Concurrent chemotherapy regimens used were weekly
Cisplatin (93%), weekly Carboplatin (5%), and Cisplatin
D1,22,43 (2%). Twenty five patients received induction
chemotherapy (IC); mostly Docetaxel/Cisplatin/5-FU
(TPF) protocol (17 patients). The majority of patients
(64%) achieved complete remission (CR). Locoregional
failure was reported in 4 patients, and salvage surgery was
done for those patients. The 3-year LRC and OS rates were
73% and 46.3% respectively. The only adverse prognostic
factor affecting OS was poorly differentiated tumors
(P=0.05). Other factors which did not significantly affect
LRC or OS were pretreatment Hemoglobin (P=0.14), T
stage (P=0.52), nodal stage (P=0.10), radiotherapy
machine used (P=0.09), received dose of RT (P=0.14), dose
per fraction (P=0.68), gaps during RT (P=0.10), use of IC
(P=0.32), and time interval between IC and RT (P=0.47).
Laryngectomy free survival (LFS) rate at 2 and 3 year were
42% and 34% respectively.
Conclusion
Concomitant chemoradiotherapy is an effective modality
for organ preservation in advanced laryngeal cancer with
LFS 42% which can be further improved by better selection
of patients. The poorly differentiated tumors significantly
affect OS.
EP-1085 Comparative study of outcomes and toxicities
in conventional 2DRT vs IMRT in locally advanced
HNSCC
K. Periasamy1, P. Baskaran Shanmuga2, S. Sambasivam1,
T.P. Soni 1, N. Patni1, G.K. Singh 2, J. Kaur2, A. Gupta 2,
K.T. Bhowmik2
1 Bhagwan Mahavir Cancer Hospital and Research Center,
Radiation Oncology, Jaipur, India
2 Safdarjung Hospital, Radiation Oncology, New Delhi,
India
Purpose or Objective
To compare conventional 2DRT with intensity modulated
radiation therapy (IMRT) in locally advanced head-neck
squamous cell carcinoma (HNSCC) patients treated with
curative-intent chemoradiation (CRT) with respect to
treatment outcome and toxicities.
Material and Methods
This bi-institutional study is a retrospective comparative
analysis of patients with biopsy-proven locally advanced
HNSCC (stage III-IV) who were treated either with
conventional 2DRT or IMRT to a radiation dose of 66-70 Gy
with concurrent chemotherapy. In this study the
treatment response to CRT, treatment related acute and
chronic toxicities, disease status and overall survival at 2
years were compared between conventional 2DRT and
IMRT. Treatment related toxicities were reported using
physician rated RTOG acute and late toxicity criteria.
Results
58 patients who were treated with conventional 2DRT and
56 patients who were treated with IMRT for locally
advanced HNSCC between 2012 and 2014 were chosen for
comparative analysis. The 2DRT arm consisted of 45% of
stage III and 55% of stage IV patients whereas the IMRT arm
had 27% and 73% of them respectively. In the 2DRT arm
53% and 47% had grade 2 and 3 acute mucositis where as
in the IMRT arm it was 80% and 5% respectively. This
difference reached statistical significance (p<0.001). But,
acute skin toxicity was only marginally higher in the 2DRT
arm than the IMRT arm.
In the 2DRT arm 84% had grade 2 and 3 acute xerostomia
while in the IMRT arm it was 45% and this difference
reached statistical significance (p=0.004). Likewise, the
difference remained statistically significant (p=0.01) with
chronic xerostomia evaluated at 1 year post treatment
with an incidence of 76% in the 2DRT arm and 38% in the
IMRT arm.
It was observed that the treatment break due to acute
radiation reactions were more in the 2DRT arm (16%) than
in the IMRT arm (9%), however this did not reach statistical
significance. However, these two modalities showed no
significant differences in response to CRT and loco-
regional control or survival at 2 years.
Conclusion
IMRT significantly reduces the incidence and severity of
acute mucositis and acute and chronic xerostomia when
compared with conventional 2DRT in the treatment of
locally advanced HNSCC. However, IMRT did not show
superiority over 2DRT with respect to response to CRT,
locoregional control and survival at 2 years.
EP-1086 Health status and phisical activity in head and
neck cancer survivors
A. Matías-Pérez1, G. Gallego-Herreros1, B. G. Díaz de
Tudanca1, P. Soria-Carreras1, A. Nieto-Palacios 1, A.
Rodríguez-Gutierrez1, L.A. Pérez-Romasanta1
1Hospital Universitario de Salamanca, Radiation
Oncology Department, Salamanca, Spain
Purpose or Objective