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 25

Abstract text Early stage oropharyngeal cancer is a rare disease with a very favorable prognosis. Current treatment guidelines recommend either radiation therapy-only or surgery-only as treatment options and the analysis of the literature fails to demonstrate any difference in terms of oncological outcome for the two modalities. Given that patients with this disease will likely be cured, it seems critical to choose a treatment, which provides excellent short- and long- term functional recovery and quality-of-life. Whilst no level 1 evidence yet exists as to which treatment will perform better in this regard, concerns over radiation therapy-based treatments have been raised as a consequence of reported late toxicities. Within this debate the pros and cons of surgery-based treatment for early stage oropharyngeal cancer will discussed and arguments presented, favoring surgery as the primary modality of treatment for this disease. SP-047 Early stage HPV related oropharyngeal cancer should not be treated with radiotherapy anymore against the motion SP-048 Early stage HPV related oropharyngeal cancer should not be treated with radiotherapy anymore: for the motion J. Klozar 1 1 University Hospital Motol, Department of Otorhinolaryngology- Head and Neck Surgery- First Medical Faculty, Prague 5, Czech Republic Abstract text The use of one modality in the treatment of early stage head and neck cancer represents an advantage for the patient regarding the toxicity and the possible use of other modalities in case of recurrence or second primary. Despite of the lack of direct comparative studies primary radiotherapy and surgery are considered to provide comparable survival in early stage oropharyngeal tumors both in the group of HPV positive and negative tumors. Up to date HPV status should not influence the choice of treatment modality. Ongoing clinical trials are supposed to answer the question of possible de - escalation of treatment in HPV positive tumors. There is a general agreement that HPV status is the most important prognostic factor in oropharyngeal cancer. Patients with HPV positive tumors are usually younger and have better survival hence the quality of life after treatment becomes more important in this group of patients. Radiotherapy particularly when combined with chemotherapy has a known acute and late toxicity and leads in considerable part of patients to xerostomia, deterioration of teeth and dysphagia. The newly developed surgical techniques are able to treat radically the early stage oropharyngeal cancer without the need of adjuvant therapy. Transoral laser surgery, ultrasonic surgery or robotic surgery even in combination with some external approaches like neck dissection result in better quality of life and should be therefore preferred. SP-049 Early stage HPV related oropharyngeal cancer should not be treated with radiotherapy anymore against the motion J. Giralt 1 1 Hospital Universitario Vall d'Hebron, Barcelona, Spain Abstract text V.Budach Germany Abstract not received

initial radiotherapy planning Computed Tomography studies to identify the localization of recurrence. Furthermore, patient and treatment characteristics were correlated with the regional recurrences to identify risk The median follow-up in our study was 26 months. Overall- and disease-specific survival at 2 years were 71.2% (95% CI 65.3-77.1) and 64.2 % (95% CI 59.2-69.3), respectively. Local, regional and distant control at 2 years was 84.1% (95% CI 79.1-89.2), 89.2% (95% CI 84.3-94.1) and 83.2% (95% CI 76.3-90.1), respectively. The actuarial rate of recurrence in the electively irradiated lymph node regions was 3.9% (95% CI 1.8-6.0) at 2 years. No significant associations could be observed between recurrence in electively irradiated lymph node regions and age, gender, tumor site, stage, or the presence of human papillomavirus in oropharyngeal cancers (table 1). factors. Results

Conclusion The actuarial rate of recurrence in the electively irradiated lymph node regions was 3.9% (95% CI 1.8-6.0) at 2 years. This incidence is comparable to recurrence rates after standard dose of 50 Gy, suggesting that lower doses to the elective neck do not result in higher regional recurrences. Debate: Early stage HPV related oropharyngeal cancer should not be treated with radiotherapy anymore SP-046 Early stage HPV related oropharyngeal cancer should not be treated with radiotherapy anymore: for the motion C. Simon 1 1 Centre Hospitalier Universitaire Vaudois, Lausanne Vaud, Switzerland