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the 5-year LRR, DDR, DFS and OS were respectively: 3.4%,
13.2%, 84.5% and 92.1%. In the PMRT group, the 5-year
LRR, DDR, DFS and OS were 4.5%, 14.1%, 85.9%, and 94.7%,
respectively. In the non-PMRT group, the 5-year LRR, DDR,
DFS and OS were 2.4%, 12.4%, 84.2% and 92.3%,
respectively. In these small single center series, there was
no difference in LRR, DDR, DFS and OS between the PMRT
and non-PMRT group. There was no significant impact of
comorbidity, T-stage, number of positive nodes, HR
status, HER2 status and adjuvant chemotherapy on the
effect of PMRT.
Conclusion
The benefit of PMRT might be limited in the unselected
elderly patients with T1-2 and 1 to 3 positive nodes. The
intensity of anti-cancer treatment including adjuvant
chemotherapy and PMRT tends to decrease in patients
with increased age at diagnosis. Larger study is needed to
identify elderly patients with relative higher risk of LRR
and metastasis, as well as the risk of toxicity to better
individualize treatment. Clear biomarkers are needed to
decide patients for whom radiotherapy can be avoided.
EP-1411 Chemo-IMRT in elderly head and neck cancer
patients
I. Ahmed
1
, S. Kotur
1
, D. Sahoo
2
, D. Sougumarane
3
, R.
Bhise
4
, K. Vinchurkar
5
, M. Kalloli
5
, A. Sanikoppa
6
1
Kle's belgaum cancer hospital, radiation oncology,
Belgaum, India
2
Kle's belgaum cancer hospital, radiaiton oncology,
Belgaum, India
3
kle's belgaum cancer hospital, radiation physics,
Belgaum, India
4
Kle's belgaum cancer hospital, medical oncology,
Belgaum, India
5
Kle's belgaum cancer hospital, surgical oncology,
Belgaum, India
6
Kle's belgaum cancer hospital, pathology, belgaum,India
Purpose or Objective
Elderly patients have been underrepresented in
prospective clinical trials that have defined standards of
care for head and neck cancer. In the era of improved
radiation techniques, improved systemic therapy and
better supportive care can claim that chemoradiation
does, in fact, improve survival for a large segment of this
population and should not be denied for fear of poor
tolerance.
Material and Methods
21 patients with locally advanced head and neck cancer
treated with SIB-IMRT and concurrent weekly cisplatin
were prospectively evaluated. After written and informed
consent, all patients were immobilised with head and neck
thermoplastic mask followed by CT simulation. Critical
structures and Planning Target volumes – high risk
receiving 70Gy (PTVHR), intermediate risk receiving 63 or
59.4 Gy (PTVIR) and low risk receiving 56 or 54Gy (PTVLR)
in 33-35 fractions over 6.5-7 weeks were defined and
planned with Eclipse version 11 planning system using 7-9
field arrangements. Concurrent Chemotherapy was
administered using weekly cisplatin 40mg/m2 or
carboplatin AUC 2 for 6 cycles. All patients were evaluated
for treatment compliance and radiation toxicities weekly.
Outcomes were analysed in terms of clinical response
evaluation using RECIST criteria, acute toxicities
according to RTOG-EORTC and overall survival using
Kaplan Meir curve.
Results
Median age of presentation was 69 years (range 65-76)
with M: F ratio of 16:5. Primary site of presentation were
hypopharynx (10), oropharynx (5) and larynx (6). TNM
stage status were T1(2),T2(5), T3(11), T4(3); N1(4), N2(1),
N3(1); Stage III(10), IVA(10) and IVB(1). All patients
received 70 Gy. Median Overall treatment time was 53
days (range 46-65 days) with treatment interruption of 1-
9 days (median 3 days). All patients received 4-6 cycles of
cisplatin/carboplatin (median 6). Acute toxicities are
shown in table. Mean weight loss was 8% (range 4-
15%).With a median follow up of 9 months (range 3-15
months), ORR were 71.5% (15 patients) had complete
response and 28.5% (6 patients) had partial response. 7
(33%) patients had recurrence with 6 loco regional and 1
distant, out of which 3 expired and 4 are alive with
disease. The overall 15 month survival rate is 75.6%.
GRADE
1
GRADE
2
GRADE
3
GRADE
4
MUCOSITIS
1(5%) 17(80%) 3(14%) 0
DERMATITIS
17(80%) 3(14%) 1(5%) 0
LARYNGITIS
8(38%) 13(62%) 0
0
ANAEMIA
6(28%) 0
0
0
NEUTROPENIA
4(19%) 0
2(10%) 0
THROMBOCYTOPENIA 1(5%) 1(5%) 0
0
Conclusion
Chemo-IMRT is feasible and well tolerated with acceptable
outcomes even in the subset of elderly patients with
locally advanced disease.
Electronic Poster: Clinical track: Other
EP-1412 Quality of life of patients after high dose
radiation therapy for thoracic carcinomas
C. Schröder
1
, R. Engenhart-Cabillic
2
, A. Buchali
3
1
Universität Giessen, Klinik für Strahlentherapie und
Radioonkologie- Universitätsklinikum Giessen und
Marburg, Giessen, Germany
2
Universität Marburg, Klinik für Strahlentherapie und
Radioonkologie- Universitätsklinikum Giessen und
Marburg, Marburg, Germany
3
Ruppiner Kliniken GmbH, Klinik für Strahlentherapie
und Radioonkologie, Neuruppin, Germany
Purpose or Objective
Quality of life (QoL) is an important factor in patient care.
In this analysis we focused on QoL before and after radio-
(chemo-)therapy (RCT) in patients with thoracic
carcinomas and its influence on clinical follow up, survival
and the correlation with treatment related toxicities.
Material and Methods
81 curatively treatable patients with intrathoracical
carcinoma (NSCLC, SCLC, esophageal carcinoma) were
included in this analysis. They received radio-(chemo-)
therapy. Patients with NSCLC were treated with 74 Gy,
patients with SCLC with 60 Gy and those with esophageal
carcinomas with 66 Gy. Eligible patients received