7th ICHNO Abstract book

7th ICHNO 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ page 33

PO-062 Intensity Modulated Radiotherapy (IMRT) for Ca Nasopharynx –A Retrospective Analysis C. Kainickal 1 , F. N 1 , R.R. Kumar 1 , M. Rafi 1 , L. Al 1 , S. Bhasi 2 , P. Geaorge 3 , R. Kunnambath 1 1 Regional Cancer Center, Radiation Oncology, Trivandrum, India ; 2 Regional Cancer Center, Radiation Physics, Trivandrum, India ; 3 Regional Cancer Center, Epidemiology & Bio statistics, Trivandrum, India Purpose or Objective To retrospectively review the clinical profile and outcomes of Carcinoma Nasopharynx (NPC) treated with Intensity Modulated Radiotherapy (IMRT) at Regional Cancer Centre, Trivandrum, South India Material and Methods From Jan 2011 to Dec 2014, Eighty one (81) NPC patients have been treated with IMRT for Ca Nasopharynx. Median age at diagnosis was 43 years (range 13-77). 67.9% of the patients were males and 32.1% were females. Stage at presentation was I in 2.5%, II in 23.5%, III in 38.2 % and IV in 35. 8% of the patients. The doses to the planning target volumes of primary tumor and involved lymph nodes (PTV66), high risk (PTV60), and low risk (PTV 54) regions were 66 Gy, 60 Gy, and 54 Gy delivered simultaneously over 30 fractions. 51.9% of patients received Neoadjuvant chemotherapy with mainly with cisplatin and 5 fluorouracil, 85.2% received concurrent cisplatin along with RT and 8.6% received adjuvant chemotherapy. Results All patients completed the planed Radiotherapy without interruption. 95.1% patients achieved complete remission in the primary site and nodal sites. Median follow-up is 59 months .19 patients in the study had relapsed of which 8 had local failure and one patient had nodal relapse and underwent salvage neck dissection. Ten patients developed systemic failure. The 5 year loco regional control, distant metastasis free survival, disease free survival and overall survival were 87.5%,87%,61.6 % and 62.5 %respectively. Five (6.2%) patients developed second primary during the follow up period. Two (2) patients had second primary in lung, 1 in breast, 1 in parotid and 1 had Non Hodgkins lymphoma. Conclusion This retrospective analysis implies that IMRT with or without chemotherapy in the treatment of nasopharyngeal carcinoma achieves good loco regional control. Distant metastasis represents the predominant mode of treatment failure. Limitations of the study include small number of patients and retrospective nature. by radiotherapy for organ preservation in Oropharyngeal Cancer G. Fanetti 1 , C. Gobitti 1 , E. Minatel 1 , A. Revelant 1 , M. Avanzo 2 , G. Pirrone 2 , J. Polesel 3 , E. Vaccher 4 , O. Schioppa 4 , F. Martellotta 4 , G. Giuseppe 5 , V. Lupato 5 , T. Baresic 6 , C. Bampo 6 , G. Vittorio 5 , E. Borsatti 6 , G. Sartor 2 , G. Franchin 1 1 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Radiation Oncology, Aviano, Italy; 2 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Medical Physics, Aviano, Italy; 3 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Cancer Epidemiology, Aviano, Italy; 4 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Medical Oncology and Immunorelated Cancers, Aviano, Italy; 5 S. Maria degli Angeli Policlinic Hospital, Division of PO-063 Induction chemotherapy followed

PO-061 Evaluating time from surgery to RT in Head and Neck cancer patients: a retrospective review of practice C. Paterson 1 , P. McLoone 1 , M. Thomson 2 1 Beatson WoSCC, Clinical Oncology, Glasgow, United Kingdom; 2 Beatson WoSCC, Therapy Radiography, Glasgow, United Kingdom Purpose or Objective Evidence suggests that starting adjuvant radiotherapy within 49 days of surgery results in better overall survival. The aim of this quality improvement project was to evaluate time from surgery to RT in patients with Head and Neck SCC in our regional network. Material and Methods A search of the radiotherapy database was performed to identify all patients receiving adjuvant radiotherapy (RT). Electronic patient records were then reviewed to identify key dates in the patient pathway as well as obtain demographic information. Results 51 patients with a diagnosis of SCC were identified who received adjuvant RT during 2017. Median age was 65 years, range 43 to 84.49% of patients had oral cavity SCC, the remainder of sub-sites included larynx (19%), hypopharynx (10%), sinonasal, neck nodes from either skin SCC or unknown primary. The median time from surgery to RT was 60 days (IQR 52-69 days). 80% of patients started RT greater than 49 days since surgery. The mean age of patients starting RT beyond 49 days was 66 years (IQR 59- 70) compared to 61 years (50-67) among patients who started within ≤49 days. The relative contribution to each part of the patient pathway between surgery and starting RT is shown in table 1. The lengthiest parts of the pathway were time from surgery to pathology review at MDT meeting, then time from mould room appointment to first RT treatment (indicative of the RT planning process) with a median time of 18 and 23 days respectively.2 separate MDTs manage all H&N SCC patients in our region, no difference in time from surgery to RT was found between MDTs. Average time from surgery to path review was lower by around 10 days for patients with cancer of oral cavity (p<0.001). Some of this time was lost later in the pathway but on average oral cavity SCC patients started RT 57.3 days after surgery compared to 63.8 days for patients with non oral cavity sites. The reasons for this are unclear.

Conclusion Time from surgery to radiotherapy is unacceptably long for the majority of patients in our network. This time interval is mostly accounted for by time from surgery to pathology review at MDT meeting then the radiotherapy planning process. Splitting the pathway into the different components has allowed identification of the most significant delays to the overall process and efforts will be focused on shortening these particular aspects. Overall time and relative contribution from each part of the pathway will be re-evaluated once changes have been implemented.