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 43

Tunisia; 3 Hopital

Universitario de Salamanca, Medical Physics, Salamanca, Spain Purpose or Objective IMRT is increasingly being used to treat Head and Neck Cancer (HNC). Helical Tomotherapy (HT) provides a highly conformal dose distribution and precise image guided patient’s setup, being specially suitable for the treatment of HNC. We report on a retrospective analysis of 123 patients with HNC treated with HT in a single institution. Material and Methods Patients with HNC of different locations consecutively treated with curative intent between September 2010 and August 2013 in a single center. The prescribed total dose was 66 – 70 Gy for high risk volume, with a simultaneous total dose of 63 Gy in intermediate risk and 56 Gy to low risk volumes. HT was given alone, concomitant with systemic treatments, and with or without induction chemotherapy. Toxicities with RTOG/EORTC criteria, loco-regional control, and specific survival rates are reported. Results Most patients, 101 (82.1%), were male. The mean age was 62 years (range 34 - 87), most frequently on the sixth decade (28.4%). Main locations were larynx (30.1%), nasopharynx (19.5%), oral cavity (14.6%), and oropharynx 12.2%. The purpose of the treatment was radical in 52% and adjuvant in 42.7% of the patients. Stage distribution was: 24.4% stage III, 54.5% stage IV-A and 15.4% stage IV- B. Acute toxicity grade ≥ 2 were dermatitis in 30.9%, mucositis in 61.8%, and xerostomia in 21.9% of the patients. Weight loss greater than 5% - 10% was observed in 38.21% - 4.9% of the patients. Main chronic toxicities were xerostomia in 38% (grade 1: 41.7%, grade 2: 58.3%) and submental edema in 21%. After a median follow-up of 28 months, local control rate was 70.73% and locoregional recurrence rate was 17.8%. Thirty two patients died, 66.7% secondary to HNC. Conclusion Radical or adjuvant HT, alone or combined with systemic treatments, is feasible and safe, providing high loco- regional control rates and low rates of chronic xerostomia. PO-083 Analysis of received doses at organs of risk in SCCHN patients treated with postoperative VMAT-SIB I. Djan 1 , B. Petrovic 1 , L. Rutonjski 1 , B. Nikolin 2 , R. Jović 3 1 Institute of Oncology Vojvodina, Radiotherapy Department, Sremska Kamenica, Serbia; 2 Institute of Oncology Vojvodina, Medical Oncology Department, Sremska Kamenica, Serbia ; 3 Clinical Center of Vojvodina, ENT Surgery Department, Novi Sad, Serbia Purpose or Objective In the past decade radiotherapy (RT) has gone through major technical improvements, such as volumetric- modulated arc therapy (VMAT). VMAT has demonstrated great advantages over intensity modulated radiotherapy (IMRT), such as significantly reduced treatment delivery time, and often better sparing of organs at risk. During last few years simultaneously integrated boost (SIB) has been implemented clinically, which enabled dose painting. Material and Methods Retrospective results for 20 patients who were irradiated after surgery in VMAT technique are presented. The SIB was applied. Included patients were diagnosed with oro, hypopharynx, larynx and oral cavity SCCHN. We have analysed mean doses received on following organs of risk: left parotide gland, right parotide gland and spinal cord.

Sfax,

Habib

Bourguiba,

Otorhinolaryngology, Sfax, Tunisia

Purpose or Objective The incidence rate of multiple primary malignant neoplasms (MPMN) ranges between 1 and 11% in all types of cancer. We report a case series of association between a head and neck (HN) and other sites cancer. Material and Methods Retrospective study of patients treated in our institution for HN carcinoma between 1993 and 2017. All HN neoplasms have been included outside of thyroid cancer. Eleven patients had MPMN. Median age was 59 years (33- 82) at first neoplasm diagnosis and 64 years (37-82) at the second one. Sex ratio was 2.7. Synchronous tumors were defined by the occurrence of both neoplasms within 6 months and metachronous tumors were those occurring beyond 6 months of initial diagnosis. Both primary and secondary tumors had histological confirmation and metastatic tumor was excluded in all cases. Overall survival (OS) was defined from the date of diagnosis (the first and then the second one) to September 2018 or death. Results Four patients (36.4%) were diagnosed with synchronous multiple neoplasms and 7 patients (63.6%) had developed the second primitive after a median time of 18 months (7- 142). The first neoplasm was in HN in 7 cases (63.6%). The majority of patients (9: 81.8%) had had curative treatment for both primitives. First Primary Occurance (months) Second primary

Classificat ion

Site

Classification Treatment

Site

Treatment

NPC NPC

T4N1M0 CCRT

M (15)

Breast Breast

T1N0M0 T2N1M0

Sr + RT Sr + CT

T3N2M0 CT + CCRT M (46)

Gingivo- mandibular T4N1M1

Bladder

T3N1M1 PRT

M (7)

PRT

Prostate

High risk RT + HT

M (18) M (13)

Larynx

T2N0M0 T4N0M0

RT

Larynx

T2N0M0 Sr

Lung

CCRT

Breast

T2N1M0 Sr + RT + CT

M (142)

Tongue

T2N1M0

Sr + CCRT

Larynx Kidney Larynx

T2N0M0 Sr + RT

M (62)

Lung NPC

RT RT

T2N0M0 Sr

S S S S

T4N1M0 T3N0M0 T4N2M1 T3N0M0

T2N0M0 CCRT T2N0M0 CCRT T2N0M0 CCRT

Bladder

CCRT

Oropharnx

Lung Lung

PRT

Larynx Sr NPC: Nasopharyngeal carcinoma; CCRT : concurrent chemo-radiotherapy ; M: metachronous ; Sr: surgery ; RT : radiotherapy; CT : chemotherapy; PRT : palliative radiotherapy; HT: Hormonotherapy; S: Synchronous. The median OS was 65 months (5-189) after first primary and 12 months (1-189) after second primary. Conclusion Even if the association between head and neck neoplasm and other sites cancers is rare, any sign must be properly explored to detect early stage lesions. Histopathological examination should be systematic and should not be avoided especially for metastasis predilection sites (eg lung). Otherwise, patient cancer should be encourage changing their lifestyle (alcohol and smoking cessation…) and informed about screening for other cancer sites. PO-082 Helical Tomotheray in Head and Neck Cancer: Retrospective Single Institution Experience C. Gil Restrepo 1 , A. Nieto Palacios 1 , A.I. Rodríguez Gutiérrez 1 , P. Soria Carreras 1 , O. Alonso Rodríguez 1 , S. García Repiso 2 , C. Martín Rincón 2 , L.A. Pérez Romasanta 1 1 Hospital Clínico Universitario de Salamanca, Radiotherapy, Salamanca, Spain; 2 Hospital Clínico