6th ICHNO Abstract Book

page 24 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ 6th ICHNO

Purpose or Objective Radical (chemo)radiotherapy offers curative treatment for patients with locally advanced laryngeal or hypopharyngeal cancer. IMRT permits safe dose-escalation and hence potential improved locoregional control given reduction in volume of normal tissue receiving high dose radiation. Material and Methods Patients with histologically squamous cell laryngeal or hypopharyngeal cancer (AJCC III-IVa/b) were randomised to dose-escalated (DE-IMRT) (primary tumour: 67.2Gray(Gy)/28 fractions(f), at risk nodes: 56Gy/28f) or standard dose (ST-IMRT) (primary tumour: 65Gy/30f, at risk nodes: 54Gy/30f) IMRT. Patients received 2 cycles concomitant cisplatin, and up to 3 cycles platinum-based induction chemotherapy. Treatment allocation (1:1) used minimisation, balancing for centre, tumour site, nodal status and planned chemotherapy. Primary endpoint was locoregional failure- free rate (LRFFR) i.e. time to locoregional relapse or completion of radiotherapy in patients with persistent disease 3 months after treatment (clinical assessment). Target recruitment was 354 patients; 100 events required to detect improvement in 2- year LRFFR from 60% to 77.5% (two-sided α=0.05, 90% power). LRFFR was analysed using competing risks methodology (with death as competing event), compared between groups by Gray’s test. Secondary endpoints (α=0.01) included toxicity (CTCAEv4.0, LENT SOMA), patient-reported quality of life and overall survival. Results 276 patients (138 ST-IMRT; 138 DE-IMRT) were randomised (2011-2015) from 32 UK centres. 84% were male, 66% had laryngeal tumours, 98% were N0-2, mean age was 62 years. Planned chemotherapy was 40% induction and concomitant, 48% concomitant only, 13% none. Recruitment stopped early due to planned interim futility analysis (subhazard ratio (SHR)>1 after 50% required events). 32/138 (23%) ST-IMRT and 37/138 (27%) DE-IMRT patients reported LRFFR events, SHR for DE-IMRT 1.22 (95%CI 0.76–1.94), p=0.42. Grade≥2 acute pharyngeal mucositis and 3 month post-RT pharyngeal dysphagia was higher with DE-IMRT (p=0.008, p=0.01 respectively). Conclusion There was no evidence for a statistically significant improvement in locoregional control with DE-IMRT compared with ST-IMRT. DE-IMRT was associated with a worse toxicity profile. OC-045 Recurrence patterns after 40 Gy to the elective treated neck in head and neck cancer. D. Nevens 1 , F. Duprez 2 , J. Daisne 3 , J. Schatteman 4 , W. De Neve 2 , S. Nuyts 1 1 University Hospital Gasthuisberg, Radiation Oncology Department, Leuven, Belgium 2 Ghent University Hospital, Department of Radiation Oncology, Ghent, Belgium 3 MaternitéUniversité Catholique de Louvain- CHU-UCL- Namur- site Sainte-Elisabeth, Radiation Oncolgy Department, Namur, Belgium 4 Ghent University Hospital, Nuclear Medicine, Ghent, Belgium Purpose or Objective To investigate the patterns of regional recurrences with emphasis on recurrences in the electively irradiated lymph node regions after dose de-escalation to 40 Gy (EQD2Gy) in head and neck cancer. Material and Methods Two hundred thirty-three patients treated with radio(chemo)therapy using 40 Gy (EQD2Gy) to the elective lymph node regions were included. All regional recurrences were reconstructed and projected on the

Conclusion With proper case selection reRT can be delivered with acceptable toxicities and is associated with improved outcomes. OC-044 ART DECO (CRUK/10/018): dose escalated vs standard dose IMRT in locally advanced head and neck cancer C. Nutting 1 , J. Morden 2 , D. Bernstein 3 , M. Beasley 4 , V. Cosgrove 5 , S. Fisher 6 , B. Foran 7 , T. Guerrero-Urbano 8 , D. Gujral 9 , K. Harrington 1 , E. Junor 10 , H. Mehanna 11 , A. Miah 12 , N. Palaniappan 13 , S. Ramkumar 14 , P. Sanghera 15 , M. Sen 16 , A. Sibtain 17 , W. Soe 18 , C. West 19 , D. Piercey 2 , S. Witts 2 , M. Emson 2 , E. Hall 2 1 The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Head and Neck Unit, Sutton, United Kingdom 2 The Institute of Cancer Research, ICR-Clinical Trials and Statistics Unit, Sutton, United Kingdom 3 The Royal Marsden NHS Foundation Trust, Radiotherapy Physics, Sutton, United Kingdom 4 Bristol Haematology and Oncology Centre, Oncology, Bristol, United Kingdom 5 St James's University Hospital, Radiotherapy Physics, Leeds, United Kingdom 6 University of Leeds, LICAP, Leeds, United Kingdom 7 Weston Park Hospital, Oncology, Sheffield, United Kingdom 8 Guy's and St Thomas' Hospitals NHS Trust, Oncology, London, United Kingdom 9 Imperial College Healthcare NHS Trust, Oncology, London, United Kingdom 10 Western General Hospital, Oncology, Edinburgh, United Kingdom 11 University of Birmingham, INHANSE, Birmingham, United Kingdom 12 The Royal Marsden NHS Foundation Trust, Sarcoma Unit, Sutton, United Kingdom 13 Velindre Hospital, Oncology, Cardiff, United Kingdom 14 Southampton General Hospital, Oncology, Southampton, United Kingdom 15 Queen Elizabeth Hospital, Oncology, Birmingham, United Kingdom 16 St James's University Hospital, Oncology, Leeds, United Kingdom 17 St Bartholomew's Hospital, Oncology, London, United Kingdom 18 Glan Clwyd Hospital, Oncology, Rhyl, United Kingdom 19 University of Manchester, Radiation Biology, Manchester, United Kingdom