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 __________________________________________________________________________________________ and associated acute and late toxicities with the disease associated with radiation therapy Material and Methods page 33

n=9) or non-evaluable (n=2) surgical margins. The disease was stage I in 5 patients and stage II in 10. They were all treated with intensity modulated radiotherapy (IMRT) using simultaneously integrated boost (SIB-IMRT). The prescribed dose was 60 to 70 Gy (2 Gy/fraction) to the high-risk planning target volume (PTV) and 50 to 54 Gy (1,64 to 2 Gy/fraction) to the low to intermediate-risk PTV. There was no contralateral nodal irradiation. After a median follow-up of 3 years, one patient had local failure and no one developed distant metastasis. Both the median overall and progression-free survival were approximately 3 years. The 3-year and 5-year overall survival were 86% and 71%, and the 3-year and 5-year progression-free survival were 100% and 80%, respectively. Three patients died due to complications related to mandibular osteonecrosis, pulmonary infection and second tumor (lung cancer). Only three patients reported acute grade 3 toxicity (mucositis, dysphagia and/or dermatitis). All other patients had acute grade 1 or 2 dysphagia, xerostomia and dysgeusia. One patient required nasogastric tube insertion before the beginning of radiotherapy and another needed one placed during the treatment. One year after the end of radiotherapy, 2 patients still had grade 1 xerostomia and one patient had osteoradionecrosis of the mandible. Conclusion In our study, close margins were the main reason to indicate adjuvant therapy in early-stage tonsil carcinoma. Despite good progression-free survival, the toxicity profile of combined modality requires caution. Further margin analysis may identify subgroups in which adjuvant radiotherapy could be avoided. PO-067 Mucosal Melanoma of the head and neck: single institution experience C. Viveiros 1 , E. Netto 2 , A. Mota 2 , R. Pocinho 1 , M. Fortunato 1 , P. Montalvão 3 , M. Magalhães 3 , F. Santos 1 1 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Radiotherapy, Lisboa, Portugal 2 NOVA Medical School UNL, Radiation Oncology, Lisbon, Portugal 3 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Otorhinolaryngology, Lisboa, Portugal Purpose or Objective Report our clinical results of treatment for Mucosal Melanoma of the Head and Neck (MMHN). Material and Methods Retrospective study of patients with pathologic proven MMHN treated with curative intent between April/05 and Jun/15. Demographic data, tumor characteristics, imaging, and treatment factors were recorded. Survival and disease-control outcomes were analyzed with Kaplan- Meier. Toxicity was scored with the CTCAE v4.0. Results 34 patients with a median age of 71 years were included; 62% female; 38% male. Tumor was located at the nasal cavity (62%), 24% in oral cavity; 9% in oropharynx; 3% in maxillary sinus; 62% were Stage III and 38% Stage IVA; 6% had c-KIT mutation. Only 21% of cases were evaluated regarding BRAF expression, none was positive. 94% were treated with surgery in which 25% involved lymphadenectomy. Pathologically 63% had R2 margins, 16% R1 margins and 16% R0 margins. 65% did adjuvant radiation therapy (RT) while only 6% definitive RT. 54% were treated with IMRT and 25% with 3DCRT. 38% did elective node irradiation. Overall treatment time of RT was below to 49 days in 63% of cases. A total of 10 patients did systemic therapy. Most of the patients had anorexia and nausea and 1 patient had platelet count decreased grade I. No grade 3 toxicity was reported. After a median follow up of 20 months, median overall survival was 13

Retrospective medical data presented 25 patients and were followed up for the survival outcomes. The patients were assessed for local and regional failures and the median follow up duration was assessed along with the survival and local control rates and disease free survival. The patients were also assessed for the acute and late toxicities and the outcomes were evaluated with appropriate statistical tests. The Radiation therapy were uniformly delivered using either 3DCRT or IMRT with standard dose of 60Gy in 30 fractions (2Gy per fraction) and multivariate analysis done for factors such as sex, age, site and extent, grade of tumor and staging of disease and the treatment modality used. Results The median follow up of the patients were found to 25 months and overall survival was found to be 80%. The disease free survival was found to 70 % and progression free survival was 65 %. The toxicities were analyzed using EORTC Toxicity scales and analyzed using appropriate statistical analysis. The outcomes were more in the form of dermatitis, dysphagia and decreased salivation which were found to be statistically significant in these cases. Conclusion Radiation therapy forms an important role in the treatment armamentarium for the unknown primaries with nodal metastases in the cervical region. The treatment modality is associated with better survival outcomes and also better tolerance to acute and late toxicities. PO-066 Early-stage tonsil cancer submitted to primary surgery and adjuvant therapy: retrospective study C. Pedro 1 , E. Netto 2 , R. Pocinho 1 , A. Mota 1 , P. Pereira 1 , M. Magalhães 3 , P. Montalvão 3 , F. Santos 1 1 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Radiotherapy Department, Lisboa, Portugal 2 NOVA Medical School UNL, Radiation Oncoly, Lisboa, Portugal 3 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Otorhinolaryngology Department, Lisboa, Portugal Purpose or Objective To review the outcomes of early-stage squamous cell carcinoma of the tonsil submitted to primary surgery and We did a retrospective study of patients diagnosed with squamous cell carcinoma of the tonsil between January 2009 and December 2014, who underwent primary surgery followed by adjuvant therapy and were staged pT1 to T2 pN0. We analyzed patient charts, imaging and clinical data regarding primary therapy, adjuvant treatment and side effects. Toxicity was graded according to Common Terminology Criteria for Adverse Events (CTCAE v4.0). Survival was estimated with Kaplan-Meier survival analysis. Results Between January 2009 and December 2014, 15 patients with pT1 to T2 pN0 squamous cell carcinoma of the tonsil were treated with primary surgery and adjuvant therapy. Most patients were male (n=13), with a median age of 58 years, current moderate to heavy-smokers (more than 10 pack-years, n=11) and/or moderate to heavy-drinkers (more than 14 units of alcohol per week, n=11). All of them underwent surgical resection with ipsilateral (n=13) or bilateral neck dissection, followed by radiotherapy with (n=3) or without (n=12) systemic therapy (high-dose cisplatin), due to positive (n=4), close (less than 5 mm, adjuvant treatment. Material and Methods