6th ICHNO Abstract Book

page 30 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ (PFS) and toxicity have been evaluated . Kaplan-Meier method has been used. Results Median follow-up: 29.7 months. Median age 51 years (range, 15-78). 6th ICHNO

with performance status of 0 to 1. All patients received 2 to 3 cycles of induction chemotherapy based on 5-FU 500 mg/m2 d1-4, Leucovorin 200mg/m2 d1-4, Epirubicin 35mg/m2 d1-2, Cisplatin 25mg/m2 d1-4 with G-CSF every 3 weeks. Concerning response rates (RR), 46% achieved a PR, 38% had a CR and 15% SD, whereas 1% could not be evaluated due to loss of follow-up. The most common adverse events were neutropenia, thrombocytopenia and anemia. One patient developed renal failure. The adverse events that occurred during treatment were predictable and manageable. After completion of the whole treatment, small residual tumors were noted either at the primary site and / or neck. Conclusion Through this retrospective study, we were able to analyze RR and safety of modified-increased FEP regimen followed by chemo-radiation for locally advanced HNSCC in Moroccan patients. Our results showed that this regimen is feasible and PO-060 Dose received by the pituitary gland during irradiation of nasopharyngeal carcinoma N. Sellami 1 , W. Siala 2 , H. Daoud 3 , W. Mnejja 3 , T. Sahnoun 3 , L. Farhat 3 , J. Daoud 3 1 Hopital Habib Bourguiba, radiation therapy, Sfax, Tunisia 2 Habib Bourguiba, radiation therapy, sfax, Tunisia 3 CHU Habib Bourguiba, radiation therapy, sfax, Tunisia Purpose or Objective Hypopituitarism is a commonly reported consequence of external radiotherapy during the treatment of nasopharyngeal carcinoma (NPC).The aim of this work was to evaluate the dose received by the pituitary gland during irradiation of NPC. Material and Methods This is a retrospective study including 91 patients treated for nasopharyngeal carcinoma between 2011 and 2016 at the department of radiotherapy; Habib Bourguiba hospital at Sfax Tunisia. Radiation therapy was performed according to a conformational technique. The prescribed dose was 68-70Gy to the nasopharynx and the initially involved nodes. A dose of 50Gy was deliverated to the rest of cervical lymph nodes. We delineated all of the pituitary gland and we studied the dose received: the minimum dose (Dmin), the maximum dose (Dmax) and the mean dose (Dmean). Then, we compared the different parameters according to the tumor stage (TNM 2009). Results The average Dmin was 37,9Gy vs. 49,4Gy respectively for T1-T2 and T3-T4 (p = 0.04).The average Dmean was 46,8Gy vs. 55,5Gy respectively for T1-T2 and T3-T4 (p = 0.007).The average Dmax was 53,8Gy vs 59,7Gy respectively for T1-T2 and T3-T4 (p = 0.02). Conclusion The occurrence of pituitary disorders depends on the dose received by the pituitary gland. Until now, there is no consensus about the dose tolerance of this gland. However, all published data agree that the maximum delivered dose should not exceed 50Gy. Those doses are generally outdated as was the case in our study. This is because of the proximity of the target volume to the pituitary gland. In fact, in our study, the dose received was significantly higher for the T3-T4 group. PO-061 Stomal underdose in post-laryngectomy radiotherapy via VMAT: phantom study and clinical case analysis S. Lee 1 , J. Zhang 2 , B.K. Lee 1 , J. Cho-Lim 2 , W.S. Inouye 2 , W.C. Lorentz 3 , M.Y. Leu 3 1 David Geffen School of Medicine at UCLA, Radiation Oncology, Los Angeles- CA, USA

Mainly men (69%), Caucasian (77.4%) locally advanced disease (93.5%) and undifferentiated (WHO III) (71%). Epstein Bar Virus (EBV) positive in 40 p. (64.5%).Only 6 patients (10%) were treated exclusivel y with RT, while the rest received chemotherapy (CT), mainly concurrent (85%). Induccti on CT was delivered to 71.% patients and/or adjuvant CT to 36% patients received neoadjuvant and adjuvant CT. The 2 and 5 year OS was 84.0%- 61,3% , LRRFS: 97% and 93,7% and PFS were 81.5% and 60.4% respectively. Main chronic toxicity was xerostomia G1 in 51% and G2 in 10%. Conclusion The treatment of NPC ( predominantly locally advanced ) using IMRT-SIB offer a result comparable to results described in endemic population with minimal chronic toxicity. PO-059 Efficacy and safety of modified-increased FEP regimen and chemo-radiation for locally advanced HNSCC A. Ouhajjou 1 , Z. Fadoukhair 1 , H. Faouzi 1 1 Oncology Center Alazhar, oncology, Rabat, Morocco Purpose or Objective The optimal sequencing of chemotherapy (CT), radiation, and surgery in the management of locally advanced HNSCC remains a subject of debate. To improve RR and functional outcomes, CT has been added into various approaches. These approaches have been applied for both patients with unresectable cancers and those with resectable disease who prefer organ preservation. Moreover, in the large Meta-Analysis of CT on Head and Neck Cancer, induction CT improved the rate of distant metastases and the CCRT improved the locoregional and distant control. Phase II and III trials using more intensive CT with three- drug regimens demonstrated a better RR than two drugs. To figure out if this promising three-drugs induction CT followed by CCRT in locally advanced HNSCC is active and safe, we evaluated induction CT using modified increased doses of FEP regimen (Fluorouracil, Leucovorin, Epirubicin, Cisplatin) followed by CCRT for locally advanced HNSCC. Material and Methods Between January 2008 and January 2015, 13 patients with histologically confirmed non mestastatic HNSCC were treated with induction CT using 5-Fluorouracil 500 mg/m2 d1-4, Leucovorin 200mg/m2 d1-4, Epirubicin 35mg/m2 d1- 2, Cisplatin 25mg/m2 d1-4 associated to G-CSF, every three weeks followed by CCRT at Alazhar Oncology Center group in Rabat, Morocco. We performed retrospective analysis for efficacy in terms of response rate and toxicity profiles. Survival data were not mature enough to be presented. Medical records were also reviewed for clinicopathologic characteristics. 9 patients were locally advanced (IIB-IVB) and 4 were recurrent HNSCC. Patients were first treated with 3 cycles of induction chemotherapy with increased doses FEP regimen (mid FEP). After induction chemotherapy, weekly cisplatin was administered concurrent with radiation. Radiation consisted of 65-70 Gy to the planning target volumes of the primary tumor and 45 -60 Gy to any positive nodal disease using 1,8 Gy per fraction. Results The median age was 62 years and 86% were male. The majority were diagnosed with locally advanced HNSCC