7th ICHNO Abstract book

page 28 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

laser microsurgery (TLM), total laryngectomy (TL) and organ preservation (OP) strategy such as radiotherapy alone (RT) or combined with chemotherapy (CT). Our aim was to evaluate the appropriateness of a multidisciplinary team’s choices retrospectively. Material and Methods 144 consecutive patients with T3 laryngeal cancer from January 2005 to December 2016 were evaluated. Each clinical case was discussed by a tumour board. The decisions of the multidisciplinary team about the best treatment modality for each patient are based on guidelines concerning T3 laryngeal cancer, tumor features, patient factors and patient’s choice. We considered two groups of patients: group A for the surgical treatment (TLM,OPHL,TL) and group B for the non surgical modality (RT or CTRT). For patients in group A transoral re-excision was performed in case of deep or more than one superficial positive margins. Those with persistent tumor after reexcision, perineural invasion, angioembolization, multiple positive nodes or ECE were submitted to adjuvant treatment. For group B the choice to do CTRT was mostly for those patients who were candidates to TL. RT dose ranged from 69.9 to 70 Gy in 33- 35 fractions. Different regimen CT were used (CDDP, CTX, TPF). Results 106 pts were in group A and 38 in group B. In group A 40/106 pts received neck dissection and 37/106 (35%) patients underwent adjuvant treatment (RT alone 29pts, CTRT 8 pts). In group B 15/38 pts received RT alone and 23/38 pts combined CTRT. Median FU was 35 months, overall 31 pts died, 11 for PD and 20 for other causes. Four pts are alive with disease, 83 are alive and free from disease. 30/144 pts had a recurrence: 19 (18%) in group A and 11 (29%) group B. Twelve patients received TL due to recurrence: 8 belonged to group A and 4 to group B. Consequently concerning the OP (organ preservation)rate, an open surgical approach and the presence of recurrence decrease the probability to spear the larynx (OR 6.05 and OR 7.40 respectively). On the other hand, belonging to group B increase the OP rate (OR 0.61). OS rates were 89%, 80% and 64% and DFS rates were 88%, 77% and 77% respectively at 1-3-5 years. For group A 1-3-5 years DFS rate was 89%, 83% and 83% and for group B 82,6%, 62% and 62% respectively. Conclusion In our experience all the options are adequate, we registered a better but no statistically difference in OS, DFS in group A than in group B. Primary endpoint in larynx preservation is survival but also laryngo- esophageal function so unimodality treatment is auspicable. To choose the best treatment modality for the single patient a multidisciplinary team must consider different factors often not clear measurable with high interobserver variability such as patient fitness and motivation or tumor resectability. PO-053 A questionnaire-based survey on current management strategies for head and neck cancer in China C. Wu 1 , L. Guang 2 1 The 4th Affiliated Hospital of China Medical University, Radiation Oncology, Shenyang City, China; 2 1st Hospital of China Medical University, Department of Radiotherapy, Liaoning, China

Purpose or Objective Head and neck cancer (HNC) is highly prevalent in China, with annual incidence rate of 15.22 per 100,000 and accounting 4.45% of all the other malignancies. However, an inconsistency has been observed in the diagnostic and treatment strategies of HNC in China. Therefore, this survey was conducted to determine the HNC management strategies in radiotherapy (RT) and other (OTH) departments of Chinese tertiary hospitals. Material and Methods This multicenter,questionnaire-based survey was conducted in 100 tier-3 hospitals of 21 Chinese cities during March 2017 and January 2018. Using a validated questionnaire for formal investigation, developed after consulting 9 HNC experts and pre-tested by 40 oncologists, we evaluated the type and stage of HNC, diagnostic and treatment strategies followed by HCPs in the participating hospitals. All results were presented as percentages. Results Of the 272 participating HCPs, 44.1% were from RT/chemoradiotherapy and 55.9% from OTH departments (36% from medical oncology). >50% of the HCPs encounter locally advanced (LA) unresectable HNC at patient’s first visit, with mHNC encountered most frequently by 12% HCPs. Among the HNCs, nasopharyngeal carcinoma (NPC) was most frequent (65%). Frequency of all types of HNC was lower than the epidemic data, except for NPC, Fig 1. Induction chemotherapy (ICT) was preferred by 92% HCPs for preserving organ function in LA HNC and 96% HCPs for tumor shrinkage. However, affordability (41%), efficacy (44%) and safety (59%) were reportedly biggest limitations in using ICT. For LA HNC, HCPs agreeing for ICT, preferred anti-EGFR combined with TPF (43%), PF (17%) and TF (9%), while remaining 31% HCPs TPF, PF or TF monotherapy. RT was considered the best department for LA HNC treatment by 58% HCPs. For r/m HNC, 84% HCPs agreed with use of targeted therapies as the first line therapy, with 78% HCPs recommending CT + anti-EGFR for R/M HNC patients TP, TPF and PF were most recommended fist line CT choices for R/M HNC. Around 59% and 44% of HCPs considered similar efficacy and toxicity with low and high dosage chemoradiotherapy, Fig 2. Importance of HPV in HNC prognosis was agreed by 92% HCPs, with 67% of the total HCPs agreeing to perform HPV test regularly. PCR was primarily used (62% HCPs) for HPV diagnosis. No effect on therapy and technical reasons (both 41%) and patients’ refusal (25%) were commonly cited reasons for not performing HPV test. High proportion of HCPs considered age before therapy selection (73%) and age >75 years as poor prognostic marker (65%). Among the sites, 74% sites had suitable facility for conducting clinical studies and 55% sites had ongoing HNC trials. A multidisciplinary team for HNC management existed in 71% of the hospitals.