6th ICHNO Abstract Book

page 28 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ 3 Nottingham City Hospital, Oncology, Nottingham, United Kingdom 6th ICHNO

Purpose or Objective The aim of this study was to describe the pattern of failure in a national consecutive cohort of patients diagnosed with subglottic squamous cell carcinoma (SCC) over a 45 years period. Material and Methods All patients diagnosed with a subglottic SCC in Denmark between 1971 and 2016 were included and followed from the first contact with the oncology center to death or May 1 2016. Patients were identified in the Danish Head and Neck Cancer Database (DAHANCA database) after combining with the Danish Cancer Registry. Information regarding patient and tumor characteristics, treatment and outcome was prospectively registered in the DAHANCA database. National patient charts were used to identify missing information. Results 169 patients were identified of whom 139 (82%) were male. The stage distribution was I=13 (8%), II=60 (36%), III=47 (28%), and IV=47 (28%). Two patients had unknown tumor stage due to death (n=1) and emigration (n=1) prior to the final staging. The tumor differentiation was well or moderate in 84 (50%) patients, poor in 36 (21%), and unknown in 49 (29%). The primary treatment intent was curative for 145 (86%) patients and palliative for 8 (5%). 143 received primary radiotherapy and six received primary surgery. Information regarding primary treatment was missing in four patients. 16 patients (9%) did not receive any primary treatment at all. The median follow- up was 5.1 years/1.9 years (patients alive/patients who died). Only one patient was lost to follow-up. 82 failures were observed among the 145 patients treated with curative intent; of these 70%, 18%, and 5% included T site, N site, and M site, respectively. 18 patients did not achieve disease control at any time despite definitive treatment. 85% of failures observed after curatively intended treatment were observed within the first two years. Salvage treatment cured 22 of the 82 patients with failure. The five-year cumulative incidences of treatment failure for patients treated with curative intent was 61%. The five-year cumulative incidence of ultimate treatment failure (failure despite salvage attempt) was 46%. For all patients, the five-year disease-specific survival (DSS) and overall survival (OS) were 50% and 37%, respectively. For patients treated with curative intent the five-year DSS was 54% and OS was 41%. Conclusion This study describes a complete national cohort of patients diagnosed with a subglottic SCC in Denmark over a 45 year period. Subglottic SCC is a rare disease with male predominance and typically diagnosed in advanced stage. The disease has a poor prognosis and more than half of patients treated with curative intent experienced treatment failure. Only few of whom were saved by salvage. PO-056 Tolerance and outcomes of radical hypofractionated radiotherapy for glottic cancer in the elderly A. Zeniou 1 , S. Ramasamy 1 , L. Murray 1 , M. Sen 1 , K. Cardale 1 , K. Dyker 1 , R. Prestwich 1 1 St James' Institute of Oncology, Clinical Oncology, Leeds, United Kingdom Purpose or Objective There is limited data to guide the management of elderly patients with head and neck cancer with regard to treatment outcomes and tolerability. The aim of this study is to review the tolerance and disease outcomes of patients aged over 70 years treated with definitive

Purpose or Objective In patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN), concurrent chemo- radiation therapy (CRT) is the current standard of care. Based on published evidence, International and European guidelines for the management of LASCCHN recommend single-agent cisplatin given 3-weekly at a dose of 100mg/m 2 as the preferred regimen. We conducted a survey of H&N cancer clinicians from oncology departments in the UK and Ireland to explore the current clinical management of LASCCHN, with a particular focus During March 2016, 55 H&N cancer clinicians from centres across the UK and Ireland were invited to complete an e- mail survey about their use of cisplatin in the management of patients with LASCCHN receiving concurrent CRT. We present here the responses of 50 oncologists (47 consultant clinical or medical oncologists [n=44 and n=3, respectively]) and 3 specialist oncology registrars/clinical fellows). Results 39% of respondents (19/49 who answered the question) stated that they use the guideline-recommended cisplatin dosing schedule (3-weekly high dose cisplatin [100mg/m 2 ]) for patients with LASCCHN receiving concurrent CRT whereas 61% (30/49) use weekly cisplatin at a dose of 35- 45mg/m 2 . The estimated percentage of patients with LASCCHN who are unsuitable for platinum-based therapy ranged between respondents from 5-60%, with a median of 30%. Poor performance status (n=33), age (n=6) and platinum side effects (n=5) were the main reasons given for patients being unsuitable. Conclusion Despite strong clinical trial evidence and International guidelines recommending high dose 3-weekly cisplatin, over half of the clinicians surveyed use weekly cisplatin for patients with LASCCHN who are receiving concurrent CRT. This may reflect current pressures within the NHS to reduce inpatient stays, and the burden of inpatient admission required to administer the 3-weekly regimen due to the greater need for supportive care than with the weekly regimen, which can be administered on an outpatient basis. Also, many clinicians perceive weekly cisplatin to be a “gentler” way of giving concomitant chemoradiotherapy. However, further research is required to confirm the efficacy and reasons for this widespread non-compliance with International guidelines. PO-055 Subglottic squamous cell carcinoma in Denmark from 1971-2016 –a report from the DAHANCA-group L. Hill-Madsen 1 , C.A. Kristensen 2 , E. Andersen 3 , J. Johansen 4 , L.J. Andersen 5 , H. Primdahl 6 , J. Overgaard 7 , N.M. Lyhne 1,7 1 Aalborg University Hospital, Department of Head and Neck Surgery, Aalborg, Denmark 2 Rigshospitalet, Department of oncology, Copenhagen, Denmark 3 Herlev Hospital, Department of oncology, Copenhagen, Denmark 4 Odense University Hospital, Department of oncology, Odense, Denmark 5 Aalborg University Hospital, Department of oncology, Aalborg, Denmark 6 Aarhus University Hospital, Department of oncology, Aarhus, Denmark 7 Aarhus University Hospital, Experimental Clinical Oncology, Aarhus, Denmark on the use of cisplatin. Material and Methods