7th ICHNO Abstract book

page 42 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

The median DFS in patients receiving a dose of more than 60 Gy versus 40-59 Gy was 26±4.6 months versus 7 ±2.78 months (p=0.007). At time of analysis complete response was seen in 37.5% patients and 23.2% were dead. The overall median survival for the entire group was 42±12.82 months.

PO-080 Radiotherapy versus concurrent chemo radiotherapy in cancers of unknown primary of Head and Neck A. Bahl 1 , A. Elangovan 1 , A.S. Oinam 1 , R. Kumar 2 , B.R. Mittal 2 , R. Verma 3 , N. Panda 3 , S. Ghoshal 1 1 Post Graduate Institute of Medical Education and Research, Radiation Oncology, Chandigarh, India ; 2 Post Graduate Institute of Medical Education and Research, Nuclear Medicine, Chandigarh, India ; 3 Post Graduate Institute of Medical Education and Research, Otorhinolaryngology, Chandigarh, India Purpose or Objective Cancers of unknown primary of head & neck (CUPHN) show aggressive behaviour with poor treatment results. Surgery or surgery with post operative radiotherapy has been used for the management of these tumors. Radiotherapy alone or with concurrent chemotherapy is an alternative approach for treating these tumors. The aim of this analysis was to evaluate the results of non surgical management of these tumors using radiotherapy alone versus chemo radiotherapy. Material and Methods Patients diagnosed as CUPHN between the years 2013- 2017 were included in this retrospective analysis. The inclusion criteria included adult patients having a histology proof of squamous cell carcinoma. Patients treated using chemo radiotherapy or radiotherapy alone were included. Previously treated patients, post operative cases AND second malignancies were excluded. Patients were staged as per the 7 th edition of the AJCC manual. All patients received either radical radiotherapy or chemo radiotherapy. Radiotherapy was delivered using conformal technique with bilateral parallel opposed portals or three field technique using 6MV photons. The radiotherapy dose ranged from 40 to 70 Gy in conventional fractionation Treatment volumes were individualized to nodal presentation and keeping in view the high prevalence of oropharangeal & nasopharnageal cancers seen in our practice. Concurrent chemotherapy was given with Injection Cisplatin 100mg/m 2 on days 1,22 & 43 or 40mg/m 2 weekly. Statistical analysis was done using SPSS v20.To evaluate variables the log-rank test was used. Kaplan–Meier method was used for survival analysis. Two sided tests were used with a p value <0.05 Results 56 patients were evaluated. Patient characteristics are given in Table 1. Concurrent chemo radiotherapy was given in 44.6% cases and radiotherapy alone in 41.1% cases. Chemotherapy was omitted in 31% patients due to poor performance status, renal impairment and active pulmonary tuberculosis. Eight patients (14.3%) received neo adjuvant or adjuvant chemotherapy. Patients receiving concurrent chemotherapy showed a complete response in 52% compared with 25.8% in those who did receive concurrent chemotherapy(p=0.056). The median disease free survival (Fig.1) with concurrent chemoradiotherapy was 19±4.41 versus 7±2.02 months with radiotherapy alone (p=0.057, log rank). In patients receiving concurrent chemotherapy acute grade 3-4 radiation dermatitis, mucositis, and dysphagia was seen in 69.4% ,72.2% and 74.2% compared with 30.6% (p=0.023),27.8% (p=0.004), 29.4%(0.015) and 25.8%(0.006) in those not receiving concurrent chemotherapy.

Conclusion Concurrent chemo radiotherapy should be the preferred treatment in non surgical management of CUPHN patients. PO-081 Multiple primary malignant neoplasms of head and neck Z. Fessi 1 , N.Fourati 1 , W. Mnejja 1 , W. Ben Kridis 2 , I. Charfeddine 3 , A. Khanfir 2 , W. Siala 1 , J. Daoud 1 1 Hopital Habib Bourguiba, Radiation Oncology, Sfax, Tunisia; 2 Hopital Habib Bourguiba, Medical Oncology,