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 __________________________________________________________________________________________ page 69

PT to treat salivary gland tumors showed to be feasible and safe; initial outcomes are encouraging. Longer follow- up is required to better evaluate the durability of local control and the possible development of late toxicities.

series patients older ≥ 70 y, did not suffer more chronic toxicity dysphagia type. PO-145 Definitive sequential radiotherapy in elderly patients with locally advanced oropharyngeal cancer F. De Felice 1 , A. Galdieri 1 , G. Abate 1 , N. Bulzonetti 1 , D. Musio 1 , V. Tombolini 1 1 Sapienza University of Rome- Policlinico Umberto I, Radiotherapy, Rome, Italy Purpose or Objective To evaluate the treatment tolerance and long term follow- up data in patients aged 70 years and older with locally advanced oropharyngeal cancer treated by definitive sequential intensity modulated radiotherapy (IMRT). Material and Methods We retrospectively analysed 15 consecutive elderly patients, with histologically proven squamous cell carcinoma of the oropharynx, staged T3-4 with or without involved lymph nodes at diagnosis, who received definitive sequential IMRT (70 Gy; 2 Gy/fraction). Performance status (PS) and Adult Comorbidity Evaluation-27 (ACE-27) scores were calculated, and their influence on treatment tolerance and clinical outcomes was analysed. Overall survival (OS) and disease-free survival (DFS)were estimated according to Kaplan-Meier method and survival curves were compared using the log-rank test. Results A total of 15 patients were included with a median age of 77 years (range 70-88 years). At baseline, all patients had a PS score of 0, whereas 8 patients (53.3%) had an ACE-27 score of 1, and the remainders (n= 7, 46.7%) had a comorbidity index of 0. All patients received the IMRT prescribed total dose. Two patients had a temporary RT interruption for a mean period of 5 days, due to severe toxicity. Globally, severe toxicity was recorded in 9 cases. Mucositis and oral pain were the most common acute side effects, classified as Grade 3 in 6 patients (40%) only. Xerostomia was reported in 13 patients (86.7%), without severe manifestation. There was no haematological toxicity. ACE-27 score was not related to higher severe acute toxicity. No patients experienced grade ≥ 3 late toxicity. Two and 5-year OS were estimated at 72.7% (95% confidence interval [CI] 0.425 - 0.888) and 63.6% (95% CI 0.327 - 0.833), respectively. Two and 5-year DFS rates were66% (95% CI 0.365 - 0.843) and 55% (95% CI 0.244 - 0.776), respectively. Figure 1 showed Kaplan Meier curves of OS and DFS. Comorbidity score did not influence survival outcomes, both OS (p = 0.46) and DFS (p = 0.55).

Poster: Special requirements for elderly patients

PO-144 Chronic radiation-associated dysphagia after curative reirradiation. Does age affect? L. Gutierrez Bayard 1 , M. Salas Buzón 1 , E. Porras Alonso 2 , S. Garduño Sánchez 1 , M. Macias 1 , L. De Ingunza Barón 1 , E. González Calvo 1 , I. Villanego Beltrán 1 , L. Díaz Gómez 1 , V. Díaz Díaz 1 1 Hospital Universitario Puerta del Mar, Radiation Oncology, Cadiz, Spain 2 Hospital Universitario Puerto Real, Otorrinolaringology, Puerto Real, Spain Purpose or Objective Chronic radiation-associated dysphagia (RAD) is a complex toxicity. The Total Dysphagia Risk Score (TDRS) was developed to predict which patients are most at risk to develop grade ≥ 2 dysphagia at 6 months following radiotherapy (RT). The mylo/geniohyoid complex (MHM) V69 ( the volume receiving ≥69 Gy), , and superior constrictor muscle (SPC V70), especially in older patients (>62-years), were associated with chronic-RAD.Acute during the course of RT are strong prognostic factors for late dysphagia. There is no effective treatment to reverse chronic-RAD in longterm survivors; and intensive and costly therapies are required for incremental gains in functionality. We have the objective to study the incidence of chronic RAD in these head and neck recurrent tumors, previously irradiated, including patients (p) over 70 years old (y). Material and Methods We evaluated 57 p with recurrent disease, between 2005 to 2014. 27 larynx, 6 nasopharynx,12 oropharynx, 6 hypopharynx and 6 oral cavity. The initial dose received 50- 70 Gy(2-2.2Gy/fraction), 25/57 received radical radiotherapy,17 /57 radical chemoradiation; other adjuvant radiotherapy, of which 8 / 57 was combined with chemotherapy. In 24 / 57 nodal recurrence (N1-N2), local 18/57 (T2-T4),6/57 local+nodal recurrence, 9/57 seconds tumor, median age 58 year (range 42–79) . Reirradiation with external 3D conformal/IMRT techniques/ and dose: 50-70 Gy. Results The acute grade 2–4 RTOG dysphagia in week 6 (RTOG G2– 4) was 75.4% (G2: 26/57, G3: 17/57). Of 57 p, 17 (29.8%) had chronic-RAD at 12 months (G2: 14/57, G3: 2/57 G4: 1/57). All of these patients had acute toxicity G3. After calculation of the TDRS, 7 patients( 2 p <62 years old/ 5p ≥ 62 y (2p ≥ 70 y)), were classified in low-risk group (TDRS 0–9); 12 patients ( 4 p <62 years old/ 8 p ≥ 62 y (4p ≥ 70 y)),in intermediate-risk group (TDRS10–18) and 38 patients ( 13 p <62 years old/ 25p ≥ 62 y (12p ≥ 70 y)),in high-risk group (TDRS > 18). MHM V69 was ≥ 79.5% in all patients with chronic-RAD at 12 months, with median age 58 y, 68% ≥ 62 years (31.5% ≥ 70 years). Conclusion Aggressive treatment of this disease , allowing long survival, even in extensive disease is superior to best supportive care. We have not seen a high incidence of severe damage in healthy tissues. TDRS can be used to predict chronic-RAD at 12 months (Grade ≥2), but also other relevant endpoints such as acute dysphagia during RT and MHM V69. In our

Conclusion Treatment tolerance, as well as survival outcomes were good in elderly oropharyngeal cancer patients treated with definitive sequential IMRT. Due to age and comorbidity, no dose or volume reduction for IMRT should be considered in this setting of patients. A prospective