6th ICHNO Abstract Book

6th ICHNO 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ page 19

PD-032 Pharyngeal constrictor muscle dose correlated with dysphagia after radiotherapy in head and neck J. Miroir 1 , J. Biau 1 , N. Saroul 2 , C. Millardet 1 , M. Lapeyre 1 1 Centre Jean Perrin, radiation oncology, Clermont Ferrand, France 2 CHU Gabriel Montpied, head and neck cancer, clermont ferrand, France Purpose or Objective Dysphagia is one of the main sequellae of radiotherapy for head and neck cancers. The aim of this prospective study was to to identify predictive factors of dysphagia in patients treated with intensity modulated radiotherapy (IMRT). Material and Methods Between 2011 and 2015, 226 patients (90 oropharynx, 48 oral cavities and 70 pharyngo-larynx, 11 nasopharynx and 7 unknown primary) were treated with IMRT with bilateral neck irradiation. Hundred had postoperative IMRT and 133 patients received concurrent chemotherapy. Prognostic factors studied were: the pharyngeal constrictor muscle mean dose, the larynx mean dose, age, location, tumor stage, xerostomia, mucositis, surgery, and concurrent chemotherapy. Results The median follow up was 17 months. The one year loco regional control and overall survival were 81 and 77% respectively. At 3 monts and one year, grade ≥ 3 dysphagia were 34 and 13% respectively. The average duration of enteral feeding was 209 days and was correlated with the pharyngeal constrictor muscle mean dose (p = 0.012). Acute dysphagia grade ≥ 3 was influenced by the concurent chemotherapy (p <0.001), pharyngeal constrictor muscle mean dose (> 55Gy, p = 0.014), mucositis (p <0.001), xerostomia (p = 0.0013), age <55 years (p = 0.016) and a location other than pharyngo-larynx (p <0.001). In multivariate analysis, only mucositis (grade 3-4; OR: 7.85), the concurent chemotherapy (OR: 5.75) and location other than pharyngo-larynx (OR: 0.19) were independent prognostic factors. At 1 year, in univariate and multivariate analysis, only the pharyngeal constrictor muscle mean dose was an independent prognostic factor with a threshold at 55Gy (19% vs 4%, P = 0.037, OR: 4.73). Conclusion The acute dysphagia is related to concurent chemotherapy.Pharyngeal constrictor muscle mean dose > 55 Gy is associated with the risk of long-term dysphagia grade ≥ 3 . PD-033 Cetuximab + RT shows an excellent long term OS in patients with both high ADCC and high EGFR M. Merlano 1 , L. Lattanzio 1 , N. Denaro 1 , D. Vivenza 1 , G. Milano 2 , R. Vigna Taglianti 3 , A. Merlotti 3 , M. Ferrero 1 , C. Lo Nigro 1 1 Azienda Ospedaliera S. Croce e Carle, Oncology, Cuneo, Italy 2 Antoine Lacassagne Cancer Institute, Oncopharmacology, Nice, France 3 Azienda Ospedaliera S. Croce e Carle, Radiotherapy, Cuneo, Italy Purpose or Objective Cetuximab induces ADCC, but the clinical relevance of this additional mechanism of action is unknown. In a multi-step proof of concept project we investigate the impact of individual ADCC activity in pts treated with cetuximab and radiotherapy (BRT) on the following outcome, by itself or in function of the cetuximab target EGFR. In the present up-date, we investigated the role of ADCC perturbation during therapy, the relationship between

stages I and II. All patients received radiotherapy, of which 62% were given 3DRT technique and 38% IMRT technique. Surgery was performed 34%, and 40% underwent neck dissection. Most relevant results are described in Table 1. There were differences in cognitive functioning according stage and neck dissection. Physical functioning was related with age and primary tumour surgery. Emotional scale was also related with surgery. Global quality of life and fatigue were worst in >65 years’ patients. Senses problems were linked to stage and surgery. There were more teeth problems regarding location. Dry mouth was related to stage and location of the tumour. Problems in opening mouth were also related to stage. Teeth problems were linked to location. Sticky saliva is found in active smokers. Regarding health status, we found larger sedentary hours in non-smokers. There were no differences between groups in MUST score, although 14% of patients were at high risk of malnutrition. Cardiovascular risk was high or very high in 62% of the patients. AUDIT score showed no problems with alcohol in the 88% of the patients. We found high prevalence of psychological symptoms (56% for anxiety and 46% for depression), with no differences between groups. There were also more not working patients related to surgery and location of the tumour.

Conclusion Our study indicates that clinical and therapeutic characteristics impact on the quality of life of HNC survivors. We have found non covered needs in physical, emotional and cognitive spheres, and in clinical issues regarding local symptoms.