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 23

with promising local control rates especially in advanced ACC. The use of tumour debulking in advanced ACC may have to be reconsidered. In cases of local tumour relapse, C12 may be a good option when surgery is not feasible but has to be used with caution.

the use of RRT for SCCHN patients as a salvage treatment approach. OC-043 Re-irradiation in head and neck cancers: A single institution prospective cohort study R. Salunkhe 1 , S. Ghosh Laskar 1 , S. Chakraborty 1 , T. Gupta 1 , A. Budrukkar 1 , V. Murthy 1 , J.P. Agarwal 1 1 Tata Memorial Hospital, Radiation Oncology, Mumbai, India Purpose or Objective To report the patterns of care and outcomes of patients of recurrent head neck cancer receiving re-irradiation (reRT) in a prospective cohort treated at a tertiary cancer Since January 2014, 180 (male-150 , female- 30) patients were screened and prospectively accrued on this IEC approved study, after obtaining informed consent. Treatment decisions were taken in a multidisciplinary clinic. Analysis was conducted on 164 patients in whom treatment details after diagnosis of recurrence were available. Descriptive analyses conducted included frequencies for categorical variables and median (range) for continuous variables. Survival was estimated using the Kaplan Meier method. Propensity score matching using nearest neighbour matching was used to match patients who received and did not receive reRT with respect to variables of age, gender, site and stage of recurrence, disease free interval, nature of recurrence (second primary / true recurrence) and if the patient underwent surgery. Outcomes data was also calculated for the matched group. Results The median age was 56 yrs (17-95yrs). Oral cavity was the commonest site of the recurrence (n = 90, 55%). The median follow-up of the entire cohort was 12 months. 110 patients were treated with Surgery with / without adjuvant reRT, while definitive re-irradiation was offered to 37 patients (33%). 17 patients (10%) received chemotherapy or best supportive care only. Most common cause of not considering reRT (n=53, 32%) were high grade of late toxicities (n=24, 45% ) and extensive nature of recurrence (n= 12, 23%). All patients received re-RT with EBRT and the median dose delivered was 60Gy. Conformal techniques were used in 91 patients (88%) mainly in the form of IMRT (94%) and 3DCRT (6%) Concurrent chemotherapy was given in 16 patients(10%). Median overall survival (OS) was not reached, while the median progression free survival (PFS) was 14.9 months (95% CI: 13.6 - 20.9 months). PFS was significantly better in patients receiving reRT (20.0 vs 10.5 months, p = 0.003). This benefit was maintained in the 106 patients in the propensity score matched group (median PFS 34.4 vs 23.6 months, p = 0.01). Grade III - IV late toxicities were seen in 11 patients (10.2%), mostly in the form of subcutaneous fibrosis. care center in India. Material and Methods

Proffered papers 3

OC-042 Re-irradiation with curative intent of squamous cell carcinomas of the head and neck in Denmark B.E. Engelmann 1 , M. Andersen 2 , C. Elmann 3 , M. Farhadi 1 , A. Gothelf 4 , C.R. Hansen 3 , K. Nowicka-Matus 5 , J.B.B. Petersen 6 , E. Samsøe 1 , H.M. Sand 2 , B. Smulders 4 , J. Johansen 3 1 Herlev Hospital, Department of Oncology, Herlev, Denmark 2 Aalborg University Hospital, Department of Oncology, Aalborg, Denmark 3 Odense University Hospital, Department of Oncology, Odense, Denmark 4 Rigshospitalet Copenhagen University Hospital, Department of Oncology, Copenhagen, Denmark 5 Aarhus University Hospital, Department of Oncology, Aarhus, Denmark 6 Aarhus University Hospital, Department of Medical Physics, Aarhus, Denmark Purpose or Objective To review outcomes of patients with recurrent squamous cell carcinoma of the head and neck (SCCHN) treated in five Danish institutions with definitive re-irradiation (RRT). Material and Methods We retrospectively reviewed the medical records and data from the Danish Head and Neck Cancer Database (DAHANCA) of patients with unresectable loco-regional recurrent or new primary SCCHN treated with definitive RRT with or without chemotherapy from January 1, 2007 through December 31, 2014 at five oncology centers in Denmark. The primary aim was to analyze disease-specific survival (DSS) and overall survival (OS) in a defined cohort and to report patient characteristics, cumulative radiation doses and systemic treatment. Results We identified 73 patients that received IMRT-based RRT. The predominant symptoms were dysphagia (22%) and pain (46%). 75% were recurrent stage IV. 74% were either pharyngeal cancer or a localized neck recurrence. RRT of 42-68 Gy resulted in cumulative radiation doses between 70 to 142 Gy (median 120 Gy). The majority was treated with hyperfractionated RRT; 41% received concomitant chemotherapy (median 5 cycles) and 35 patients (48%) had surgery at some point. Only one patient terminated treatment prematurely, all others completed the full treatment course. The most prevalent side effects were difficulty swallowing (37%), grade 3 mucositis (29%), and 24 patients had a nasogastric feeding tube, which was permanent at last follow-up in 10. Survival data were available for 70 patients. With a median follow-up for death of 15.8 months (range 1.4- 100.7), the 5-year DSS was 35% and the 5-year OS 27%. Twenty-four patients (34%) were still alive at the end of the study. Conclusion This nation-wide study confirms that IMRT-based RRT can achieve long-term disease-control in a about one third of patients with recurrent SCCHN. Compliance to definitive multimodality treatment was high and the data support