6th ICHNO Abstract Book

page 72 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ 6th ICHNO

staged using cross-sectional imaging. Early laryngeal cancers (T1N0) were excluded. A retrospective chart review determined patient demographics, tumour and treatment factors. Survival analysis was performed using the Kaplan-Meier method, and comparisons between groups used the log rank test. Results Median age was 82 years (range 80-92). Patient demographics are shown in Table 1. 42 (68%) had stage III- IVb disease. Radiotherapy was delivered using volumetric modulated arc therapy (VMAT), 5-7 field intensity modulated radiation therapy (IMRT), or conformal technique. Prescribed doses were: 52.5-55Gray in 20 fractions and 60-66Gray in 30 fractions. Two (3%) patients received synchronous cetuximab and two (3%) were treated in the NIMRAD trial (+/-synchronous nimorazole). Four (6%) had a neck dissection prior to radiotherapy. Eight (13%) were electively treated as inpatients. Six (10%) did not complete radiotherapy: four (6%) due to co- morbidities and two (3%) due to poor tolerability. 43% patients required acute admissions for nutritional support and symptom control. Fourteen (44%) required tube feeding prior to treatment and an additional 17 (27.4%) commenced enteral feeding during radiotherapy. The median enteral tube feeding duration was 3 months. Grade 2-3 mucositis occurred in 28 (60%), and Grade 2-3 skin reactions in 21 (57%) patients. Median overall survival was 27.3 months (range 0.7- 62.4m); and 2-year overall survival was 57%. There was a non-significant trend towards improved survival with performance status (PS) 0-1 compared to PS 2-3, (28.9m v 21.0m, p=0.1372). Patients who initially weighed <60kg at start of radiotherapy had significantly worse survival than those ≥60kg (5.7m v 28.9m, p=0.0033).

Conclusion We show promising survival outcomes in very elderly patients treated mainly with radiotherapy alone for head and neck cancer. We note poor survival outcomes associated with low pre-treatment weight. Optimisation of nutritional status may be an important factor to improve outcomes for this patient group. PO-150 Age ≥70 is not an adverse prognostic factor for accelerated radiotherapy in head and neck cancer C. Terhaard 1 , N. Kasperts 1 , H. Dehnad 1 , E. Smid 1 , L. Janssen 2 , R.G. Wiggenraad 3 , C.P.J. Raaijmakers 1 1 UMC Utrecht, Radiation Oncology Department, Utrecht, The Netherlands 2 UMC Utrecht, Head and Neck surgical oncology Department, Utrecht, The Netherlands 3 RCWEST- Medisch Centrum Haaglanden., Radiation Oncology department, Den Haag, The Netherlands Purpose or Objective Based on meta-analysis it is stated that accelerated fractionation for patients with intermediate staged head and neck cancer above an age of 70 years has no benefit, with however an increased risk of complications, compared to patients younger than 70. In a large dataset we evaluated the prognostic significance for outcome of age in a group of patients with a WHO performance status of 0 to 1 . Material and Methods Since 1998 we treat advanced T2 glottis (based on volume and/or impaired mobility of the vocal cord), T2 supraglottis , T3 glottis/ supraglottis, T2/ T3 hypopharyngeal cancer, including nodes smaller than 3 cm, with accelerated fractionation. A dose of 47 Gy is given in 10 fractions of 2 Gy, followed by 15 fractions of 1.8 Gy, week 3-5, on the primary tumor and the elective neck levels. A boost dose of 22.5 Gy in 15 fractions of 1.5 Gy is given as a first daily fraction in week 3-5, at least 6 hours before the second fraction. Results have been published previously 1 . Until July 2014, 310 patients were treated with this schedule with a minimum follow-up of 2 years, median FU 5 years. Eighty-two patients were ≥ 70 years (O) (70-87, median 75), WHO performance 0-1, 228 < 70 years (Y) (32-69, median 59). Distribution of T-stage was for T2, T3 and T4, 59%, 30%, and 8%, respectively.; 35% was N+. Distribution of prognostic factors was equal for gender and Stage. Distribution of tumor location was larynx, hypopharynx, and oropharynx in 77% vs. 79%, 11% vs. 16%, and 12% vs. 5%, for group O and Y respectively. A smoking history was positive in 99% and 87 % for Y vs. O (p=sign.). Continuation of smoking occurred in 39% vs. 11% respectively (p=sign.) Results Five years local recurrence e free survival was 86% vs. 84% for Y vs. O (p=n.s.). Actuarial 5 years disease free survival