7th ICHNO Abstract book

page 40 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

treatment of head and neck cancer, the alternative use of weekly (w) CDDP is widely adopted, because is thought to be less toxic and more manageable. This retrospective analysis aims to compare toxicity and survival of these two schedules. Material and Methods Patients eligible for the analysis had meso/hypo- pharyngeal or laryngeal locally advanced disease and were treated with radical radio-chemotherapy. Patient, disease and treatment characteristics were analysed and related with toxicity and survival, using χ2-test, log-rank test and propensity score (age, T, N, M) analysis (SPSS®). Results Between Jan 2010 and Jan 2017 166 patients were treated in two large reference Italian Centres, 52 pts with 3w (100mg/m 2 ) and 114 pts with w-CDDP (40mg/m 2 ). Patients treated with w-CDDP had a statistically significant older age (p=0.005), worse Karnofsky performance (p=0.000); higher smoking and alcohol consumption (p=0.000). Moreover, in this group there were less meso-pharyngeal (65% vs 90%; p=0.001) and N2- 3 disease (71% vs 84.7% p=0.02) and more T3-4 disease (54% vs 38%; p=0.05). All patients were treated with equivalent RT doses. The CDDP cumulative doses were equivalent in both groups (p=0.10); the rate of RT interruption was higher in the w group.Clinical response was similar in the two groups (p=0.081 and p=0.984 in relation to N and T response, respectively). Local relapse rate is higher in w-group (17.65% vs 11.5%) while metastases occurrence is worse in 3w-group (4.4% vs 19.2%) (p=0.01). Anaemia, leukopenia, renal toxicity, mucositis and dysphagia rates were similar in the two groups. Thrombocytopenia, nausea and vomiting were more frequent in the w-group (p=0.01 and 0,007 respectively). Overall survival was influenced by tumour site (better for meso-pharyngeal disease p=0.04), nodal stage (better for N0-1 p=0.01), and nodal response to treatment (better for CR p=0.004) but not by the CDDP schedule (p=0.433). Relapse free survival was influenced only by the nodal response to treatment (better for CR, p=0.015). All survival data were confirmed after propensity score analysis. Conclusion With the limits of a retrospective analysis the study confirmed the equivalence of the two CDDP schedules in terms of survival outcomes. The higher rates of some toxicities and the higher rates of treatment interruptions in the w group could be explained by the worse patients and disease characteristics at baseline but the point remain challenging, eliciting discussion. Data from literature are up to now inconclusive and a large prospective randomised study comparing these two schedules is desirable to define the optimal chemotherapy association for patients treated with radical intent. PO-079 Up-front surgery and adjuvant RT of paranasal sinuses carcinoma: single center retrospective study. R. Da Silva Colaco 1 , E. Netto 1 , S. Esteves 2 , R. Pocinho 1 , A. Mota 1 , M. Labareda 1 , J. Fonseca 1 , I. Antão 1 , F. Santos 1 , P. Montalvão 3 , M. Magalhães 3 1 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Radioterapia, Lisboa, Portugal; 2 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Clinical Research Unit, Lisboa, Portugal; 3 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Otorrinolaringologia, Lisboa, Portugal

Material and Methods We retrospectively reviewed the data from 70 patients with non-metastatic nasopharyngeal carcinoma who received IMRT-SIB from January 2007 to December 2015. High-risk PTV was treated with a daily dose of 2.12 Gy and a total dose of 69.96Gy. Low-risk PTV was treated with a daily dose of 1.64 Gy and a total dose of 54.12 Gy. Patients received concurrent chemotherapy during the course of the RT with intravenous administration of 100 mg/m 2 cisplatin every 3 weeks or 30-40 mg/m 2 weekly. The induction chemotherapy regimen was TPF (docetaxel/cisplatin/5-fluorouracil) or PF every 3 weeks for 2-3 cycles. Post-radiation adjuvant chemotherapy with PF (two-three cycles) also was used as option treatment. We analyzed the survival outcome and late toxicity outcome (scale CTCAE v4.03). Results 73% of all cases were men; median age was 51 years (range 15 - 79). Non-keratinizing carcinoma was the most common histological type (76.9%) and EBV was positive in 44 (62.9%). According to the AJCC 7 th Edition staging system 94.3% of cases were locally advanced disease, stage III-IVB. Only 7 patients (10%) were treated exclusively with RT, while the rest received chemotherapy, mainly concurrent (88.4%). 29 (41.5%) patients received induction chemotherapy. 25 (35.7%) patients received neoadyuvant and adjuvant chemotherapy. Response rate 8 weeks after ending radiotherapy were: complete response 65.7%, partial response 29.9%, stable disease 1.5% and progressive disease 2.9%. At a median follow-up of 62 months (range 4-136), 9 patients experienced local regional failure and distant metastasis occurred in 12 patients. 1-ys, 3-ys and 5- ys Disease Free Survival were 90%, 79% and 67%, respectively while 1-ys, 3-ys and 5- ys Overall Survival were 98%, 86% and 74% respectively. The most common late adverse effects were: xerostomia, dysphagia, and fibrosis. Grade 3 dental damage and xerostomia occurred in 1 case (16%) and 1 (2.1%) respectively. No case of grade IV toxicity was observed. Conclusion IMRT-SIB combined with concurrent chemotherapy or plus neoadjuvant or adyuvant chemotherapy resulted in promising rates of local regional control with acceptable rates of late side effects in patients with nasopharyngeal carcinoma. PO-078 Radio-chemotherapy for Heand and Neck cancer: retrospective comparison between weekly and three-weekly CDDP M. Gerardi 1 , M. Buglione 2 , D. Alterio 1 , M. Maddalo 2 , D. Greco 2 , M. Augugliaro 3 , A. Alghisi 2 , M. Bonù 2 , L. Costa 2 , A. Ferrari 4 , G. Marvaso 1 , D. Tomasini 2 , M. Cossu Rocca 5 , R. Orecchia 6 , S.M. Magrini 2 , B.A. Jereczek-Fossa 3 1 European Institute of Oncology- IRCSS, Division of Radiation Oncology, Milan, Italy; 2 University and Spedali Civili, Radiation Oncology Department, Brescia, Italy; 3 European Institute of Oncology- IRCSS- and University of Milan, Division of Radiation Oncology and Department of Oncology and Hemato-Oncology, Milan, Italy; 4 European Institute of Oncology- IRCSS, Division of Radiation Oncology, Milan, Italy; 5 European Institute of Oncology- IRCSS, Division of urogenital and Head and Neck medical oncology, Milan, Italy; 6 European Institute of Oncology- IRCSS, Scientific Direction, Milan, Italy Purpose or Objective Even if three weekly (3w) CDDP is considered the standard chemotherapy given concurrently with radiotherapy in the