7th ICHNO Abstract book

page 44 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

Student’s t test was applied in order to analyse differences among received doses at organs of risk and different tumor sites. The applied treatment dose for the low risk patients was 60Gy in 28 fractions on tumor bed and 50.4Gy in 28 fractions on bilateral lymph nodes level. For the high risk patients with the positive lymph nodes the delivered treatment dose was 60Gy in 30 fractions on tumor bed, and 54Gy in 30 fractions in the positive lymph nodes region. For the high risk patients with the positive margins 66Gy in 30 fractions on tumor bed and 60Gy in 30 fractions on the lymph node region with extracapsular extension was applied. Treatment plans were generated by Monaco TPS (manufacturer Elekta). Results The study group included 15 males and 5 females. Among them 13 were the low risk patients and 7 high risk patients. Eighteen patients were diagnosed in stage 3 and two patients where stage 4. The mean values of the received doses on organs of risk are presented in Table 1. Table 1. The mean received doses (Gy) on organs of risk for SCCHN patinents treated by postoperative VMAT-SIB No significant differences in received mean doses on organs of risk were observed regarding the applied different treatment doses. The received dose on right parotide gland in comparison between oral cavity and hypopharynx SCCHN showed p=0.089, which is not statistically significant but it is a bit above the threshold, which may indicate possible significant difference in the case of larger sample. Similar case was for the received dose on spinalcorde in comparison between oral cavity and larynx (p=0.068). Statistically significant differences were registered in received doses on right and left parotide glands in comparison between hypopharynx and larynx SCCHN (p=0.001 and p=0.020, respectively). Conclusion The VMAT-SIB provides good sparing of organs of risk as well as delivery of different daily doses (dose painting). Our results show that the delivery of higher doses is applicable without the statistically significant increase of the received doses on organs of risk. PO-084 Quantification of the impact of radiologic imaging revision in Head and Neck cancer D. Alterio 1 , L. Preda 2 , S. Volpe 1,3 , C. Giannitto 2 , G. Riva 1,3 , A.F.K. Pounou 1,3 , M. Atac 4 , G. Giuliano 4 , A. Ferrari 1 , G. Marvaso 1 , S. Durante 1,3 , S. Arculeo 1,3 , I. Turturici 5 , M. Cossu Rocca 6 , M. Ansarin 4 , M. Bellomi 2 , B.A. Jereczek- Fossa 1,3 , R. Orecchia 7 1 European Institute of Oncology IRCCS, Department of Radiation Oncology, Milan, Italy ; 2 European Institute of Oncology IRCCS, Department of Radiology, Milan, Italy ; 3 University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy; 4 European Institute of Oncology IRCCS, Department of Head and Neck Surgery, Milan, Italy; 5 Università di Roma Tor Vergata, UOC Radioterapia, Roma, Italy; 6 European Institute of Oncology IRCCS, Department of Head and Neck and Urogenital Medical Oncology, Milan, Italy; 7 European Institute of Oncology IRCCS, Scientific Directorate, Milan, Italy Organ of risk Minimum Maximum Mean SE Left parotide gland 6.71 Right parotide gland 6.53 29.17 35.93 44.17 17.67 1.53 20.74 1.65 36.57 1.29 Spinal corde 19.17

Purpose or Objective Although the role of the radiologist as a core member of the multidisciplinary team (MDT) for Head and Neck (HN) cancer management has been increasingly advocated, a quantitative analysis on the impact of imaging revision is not available in currently published works. To address this unmet need, the current study provides a full report of MDT meetings held at a tertiary care cancer center at the presence of expert dedicated HN radiologists. Material and Methods All cases discusses at MDT meetings from April 2014 to March 2017 for whom a radiologic revision was required were retrospectively reviewed at the presence of two expert radiologists (LP and CG, having 15 and 5 years of experience, respectively). Inclusion criteria were: 1) clinical and/or radiological suspicion or histologically- proven diagnosis of HN cancer, 2) availability of a written medical record of the MDT discussion and final radiological report 3) follow-up length of at least 12 months, 4) written informed consent for the use of personal data for educational and scientific purposes. Both malignant and benign tumors were included. Exclusion criteria were adjuvant treatment (i.e. radiation treatment alone or in association with systemic treatment) and/or diagnosis of thyroid cancer. Only computed tomography (CT) and magnetic resonance (MR) imaging were considered. The following descriptors were analyzed: 1) any changes of radiological staging (per Tumor Node Metastasis, TNM, staging system 7th ed.) 2) any changes in treatment strategy. The latter were categorized as either “major modifications” (i.e. MDT non indication to surgery in favor of radiotherapy± systemic therapy) or “minor modifications” (i.e. MDT indication to an alternative approach:open versus minimally-invasive surgery). Accuracy of MDT indication-to-treatment was verified through follow-up data (pathological specimens and/or subsequent imaging and/or clinical information). Results Table. 1 represents the clinical aim of radiologic imaging revision cases’stratification according to radiologic indication is represented in Fig. 1 . Major and minor modifications were applied in 13% and 11% of the considered cases, respectively. Follow-up showed that radiology-driven MDT decision was correct in 117 of the 118 cases with available follow-up (99%), with 43 patients having a histological confirmation. Conclusion Data emerging from our work strongly support the inclusion an expert HN radiologist in the core of each institutional HN MDT. Further efforts of prospective nature are warranted in order to assess whether imaging revision translates into improved oncological outcomes in this clinical setting. PO-085 Post-radiotherapy N3 nodal response in HPV positive SCC: a systematic review J. Virk 1 , M. Ingle 1 , C. Podesta 1 , D. Gujral 1 , Z. Awad 1 1 Imperial College Healthcare NHS Trust- Head and Neck Unit- London- United Kingdom, medical and surgical oncology head and neck team, london, United Kingdom Purpose or Objective Management of metastatic nodal disease from primary mucosal head and neck squamous cell carcinoma (SCC) is controversial. Traditionally, planned neck dissection followed primary treatment with (chemo)radiotherapy. With improved imaging techniques (particularly positron emission tomography, PET), advances in RT techniques,