6th ICHNO Abstract Book

page 68 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ Conclusion 1 APSS Trento, U.O. Protonterapia, Trento, Italy 6th ICHNO

In our study, surgery and radiation therapy produced excellent locoregional control similar to the published literature. Solid growth pattern was associated with worse OS, DFS and LRC. Our study also shows the impact of overall treatment time in DFS and LRC. Longer follow-up is encouraged to better understand the natural history of this carcinoma. PO-142 A 10-year review of primary major salivary glands carcinomas H. Magalhães 1 , F. Pereira 1 , C. Vieira 1 , A. Isabel 1 , M. Jácome 2 , J. Dinis 1 1 Instituto Português de Oncologia do Porto Francisco Gentil- EPE, Medical Oncology, Porto, Portugal 2 Instituto Português de Oncologia do Porto Francisco Gentil- EPE, Pathology, Porto, Portugal Purpose or Objective Primary salivary gland malignancies, which comprise a diverse group of histological entities, represent less than 5% of all new head and neck cancers. Currently, surgical resection remains the standard of care, with adjuvant radiotherapy performed in selected cases. Chemotherapy can be used in metastatic or recurrent setting, but has limited effect. Our objective was to review a 10-year experience of a single institution on major salivary glands carcinomas, aiming on demographics, treatment and outcomes. Material and Methods A pathology database of salivary glands tumours was reviewed for all cases of a single institution from January 1995 until July 2016. Then we selected all the patients with histopathological diagnose of primary major salivary gland carcinoma from March 2006 to July 2016. Results A total of 933 patients were identified, with 33% of them with malignant histology. After excluding patients with metastasis from other sites, we identified, in the last 10 years, 93 patients with primary major salivary gland carcinoma. In this sample of patients, the median age at diagnosis was 63.1 years (age range 17-90 years), and 51% (n= 48) were male. The majority of the primary tumours were from the parotid gland, representing 76% of all cases. Salivary duct carcinoma was the most frequent histological type (21,5%), followed by adenoid cystic carcinoma (16,1%) and mucoepidermoid carcinoma (13,9%). About 25% of patients had recurrent disease, with 41,6% (n=10) of patients with salivary duct carcinoma; median time to recurrence was 21.52 months. The 5-year survival was 90.2% for stage I; 85.2% for stage II; 66.6% for stage III; and 6.4% for stage IV. Median overall survival for stage IV was 30 months (95% confidence interval 19.67- 40.32). Only 5 patients received palliative chemotherapy based on doxorubicin and platinum agent. Conclusion Our analysis of this retrospective cohort is in accordance with the literature in respect of median age at diagnosis, gender predominance and outcomes, with the exception in terms of most frequent histological type in our series, the salivary duct carcinoma (estimated to represent only 1-3% of the salivary tumours), probably because our institution is a high-specialized oncology center. Patients with advanced disease have worse survival, and only few patients were treated with palliative chemotherapy, making it difficult to draw conclusions. PO-143 Salivary gland tumours: preliminary results of the Trento Protontherapy Centre I. Giacomelli 1 , D. Scartoni 1 , M. Cianchetti 1 , F. Dionisi 1 , S. Lemoine 1 , M. Amichetti 1

Purpose or Objective To report the initial experience in treating salivary gland tumors with protontherapy (PT) Material and Methods Between October 2014 and October 2016, 20 patients (pts) (10 M, 10 F) have been treated with PT. Median age at PT was 58.5 years (range,23-90). Median KPS was 90 (80-100). Stage was II: 2; III: 3, IVa: 11; IVb: 2; IVc: 1 and 1 benign pleomorphic adenoma. Parotid gland was involved in 8 cases, submandibular in 3. Minor sites were: maxillary sinus 6; hard palate 1; nasopharynx1; skull base 1. Pathology was: 10 adenoid cystic carcinoma, 6 mucoepidermoid carcinoma, 1 SCC, 1 adenocarcinoma ex pleomorphic adenoma, 1 pleomorphic adenoma, 1 other. Eight pts received one surgical resection, 5 pts 2 resections, 4 pts 3 resections. Three pts had biopsy only. Eleven pts were treated at their initial disease course, 7 in adjuvant setting (1 R0; 4 R1; 2 R2), 3 with definitive intent, one palliative. Nine pts were treated for recurrent disease, 5 with adjuvant intent (1 R0, 4 R1), 3 with radical intent, 1 palliative. Re-irradiation (Re-RT) was performed in 4 cases. Acute and late toxicities have been reported according to CTCAE scale version 4.0. Results Median follow-up was 6.1 months (range, 0-12.4). All pts but one completed their treatment without any break due to acute toxicity. Withdrawal from PT was for patient’s personal conviction. PT was delivered in all cases with single field optimization-active scanning technique. Median definitive total dose was 69.3 Gy(RBE) (range, 60- 70 Gy(RBE), median adjuvant dose 66 Gy(RBE) (range, 60- 70.4 Gy(RBE). Pts receiving Re-RT had been previously irradiated at a median dose of 60Gy (range, 60-70 Gy). PT Re-RT median dose was 66 Gy(RBE) (range 60-70 Gy(RBE). In one case PT was given as the third RT course, to a radical dose of 70 Gy(RBE). No acute toxicity > grade 3 was observed. Grade 3 acute cutaneous toxicity was seen in 4 pts. Oral and sinonasal mucositis of grade 3 occurred in 2 pts. Other acute toxicities < grade 3 are listed in the table below. One diabetic patient experienced surgical wound dehiscence one month after PT completion. Cutaneous G1 late toxicity was seen in 3 pts, grade 2 in one pt, 2 patients developed oedema and fibrosis of the subcutaneous tissues and 1 pt cutaneous telangiectasia G1. Two cases of trismus G1 and one case G2. Two pts had necrosis of irradiated mucosa but it was limited to a little area in both cases. At the time of the analysis, 13 pts are free of disease, 4 pts have stable disease, 2 pts in local control developed distant metastasis, one pt (treated with palliative intent) died for local recurrence and distant metastases.

Acute Toxicity

Tot. pts G1 G2 G3

Cutaneous Mucositis

16 12

1 11 4 6 4 2

Wound dehiscence 1

1

Xerostomia

3 2 5 5 4 2

3

Fatigue

1 1 4 1 2 3

Conjunctivitis

Otitis

Alopecia Dysgeusia

4

1 1

Conclusion