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 __________________________________________________________________________________________ 1 Hospital Habib Bourguiba, Radiotherapy oncology, Sfax, Tunisia 2 hospital Habib Bourguiba, medical oncology, sfax, Tunisia 3 hospital Habib Bourguiba, oto-laryngology, sfax, Tunisia Results The average Dmin was 6Gy vs. 7,9Gy respectively for N0- N1 and N2-N3 (p = 0.3). The average Dmean was 41,2Gy vs. 43,5Gy respectively for N0-N1 and N2-N3 (p = 0.3). The average Dmax was 59,6Gy vs. 65,4Gy respectively for N0-N1 and N2-N3 (p = 0.07). The average D50% was 48Gy vs. 48,7Gy respectively for N0-N1 and N2- N3 (p = 0.7). Conclusion page 35

Purpose or Objective Standard treatment of nasopharyngeal carcinoma (NPC) is radiotherapy frequently associated with chemotherapy in advanced disease. However, after conventional radiotherapy results remain poor with a high rate of both local relapse and distant metastasis. The aim of our study was to evaluate the impact of a split course bifractionated radiotherapy regimen. Here, we present the 10-year follow-up results. Material and Methods From January 1997 to September 2003, 154 patients with M0 histologically proven NPC were treated in the Habib Bourguiba hospital, Sfax Tunisia. Patients with locally advanced nodal disease (N2–N3) received induction chemotherapy. All patients were randomized to receive either conventional radiotherapy at 2 Gy/fraction/day, 5 days/week to 70 Gy/7 weeks or split course bifractionated radiotherapy at 1.6 Gy/fraction, twice daily, 5 days/week to 70.4 Gy/ 6 weeks. Results Update of survival data was done in 2016. With a median follow-up of 13, 6 years, 10-year overall survival (OS) did not differ between the two treatment arms: 52% for the conventional radiotherapy versus 49, 7% for the split course regimen (p= 0, 3). Loco regional and distant free survival rates were, respectively (55% and 55, 4%), in conventional arm and (51, 1% and 51, 5%) in bifractionated arm, the difference was not statistically significant. There was more grade II–III skin fibrosis (68, 9% vs. 64, 9%) and more grade II-III xerostomia (49, 3% vs. 48%) in experimental arm, but the difference being statistically non significant. Conclusion Compared with conventional radiotherapy, split course bifractionated radiation therapy failed to demonstrate significant improvement in locoregional control or overall survival even after 10-year follow-up. PO-071 Dose to the thyroid gland during irradiation of nasopharyngeal carcinoma W. Siala 1 , N. Sellami 1 , H. Daoud 1 , M. Kallel 1 , W. Mnejja 1 , L. Farhat 2 , J. Daoud 1 1 Habib Bourguiba hospital, Radiotherapy oncology, Sfax, Tunisia 2 Habib Bourguiba hospital, radiotherapy hospital, sfax, Tunisia Purpose or Objective The thyroid dysfunction is a frequent late toxicity observed after radiotherapy of nasopharyngeal carcinoma (NPC).The aim of this study is to evaluate the dose received by the thyroid gland during irradiation of NPC. Material and Methods This is a retrospective study including 87 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 the thyroid gland and we studied the dose received: the minimum dose (Dmin), the maximum dose (Dmax), the mean dose (Dmean) and the dose to 50% of the thyroid (D50%). Then, we compared the different parameters according to the node stage (TNM 2009).

The Irradiation of the thyroid gland cannot be avoided during radiotherapy for nasopharyngeal carcinoma. There is no consensus about the dose constraints. It seems preferable to not irradiate more than 50% of thyroid volume with a dose superior to 50Gy. These constraints were sometimes exceeded in our study especially for patients with N2-N3 nodal involvement. PO-072 Compliance and acute toxicity of chemoradiotherapy for undifferentiated nasopharyngeal cancer N. Jovanovic Korda 1 , T. Ursulovic 2 , S. Vucicevic 3 , V. Vujanac 1 , M. Kreacic 4 1 Institute for Oncology and Radiology of Serbia, Radiotherapy department for head and neck cancer, Belgrade, Serbia 2 Institute for Oncology and radiology of Serbia, Clinic of medical Oncology, Belgrade, Serbia 3 Institute for Oncology and radiology of Serbia, Radiotherapy Department, Belgrade, Serbia 4 Institute for Oncology and Radiology of Serbia, Clinic for Medical Oncology, Belgrade, Serbia Purpose or Objective To evaluate treatment compliance and acute toxicity for patients with locally advanced undifferentiated nasopharyngeal cancer treated with induction Cisplatin- based chemotherapy followed with concurrent chemo radiation and adjuvant chemotherapy. Material and Methods A total of 73 patients with locally advanced, non metastaticundifferentiated nasopharyngeal cancer were included. 42 patients (57.5%) were diagnosed in clinical stage IV and 31 (42,11%) stage III. Two cycles of chemotherapy with Epirubicin ( dose of 90 mg /m2 ) and Cisplatin (60mg/m2 ) were administrated in induction and adjuvant approaches, and two cycles Epirubicin and Cisplatin with dose 60mg/m2, were given concurrently with radiotherapy on day 1 and 21 . Three dimensional radiotherapy was delivered with total dose 70Gy , using conventional regimen of fractionation. Results All patients received induction chemotherapy. Three patients developed progression of disease after induction chemotherapy 69 patients (94%) were treated with 3D conformal radiotherapy and received total dose of 70Gy using conventional regimen of fractionation . 67 patients received II cycles chemotherapy concurrently with radiation. After concurrent chemo radiation , 57 patients were treated with adjuvant chemotherapy. 56 patients (77%)completed treatment according to protocol and protocol modifications were observed in 23% (17 patients). Most common acute toxicities were mucositis, dysphagia and skin toxicity. Severe mucositis grade 3/4 was observed in 47patients (64, 4 %) Most common hematological toxicities grade 3/4 was neutropenia , seen in 17 patients (23, 3%) . Two patients developed febrile neutropenia in concomitant chemoradiation and two in adjuvant treatment. No treatment related death was observed. After 5years, there were no relapses of disease in 65, 3% patients.