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 51

patients with recurrent/metastatic SCCHN. The demonstrated effectiveness and safety profile with low- grade toxicities, similar to the phase II trial by the Spanish Head and Neck Cancer Cooperative Group, are optimistic results that support its use mainly in fragile patients (first line) and after failure of platinum base regiments (second line). PO-100 HDR Interstitial brachytherapy in Recurrent Head and Neck cancer: An effective Salvage option V. Pareek 1 R. Bhalavat 1 , M. Chandra 1 , L. Nellore 1 , K. George 1 , D. Borade 1 , K. Kalariya 1 , Z. Moosa 1 , N. Reddy 1 , A. Srivastava 1 , A. Kapoor 1 , D. Kawale 1 , P. Bauskar 1 1 Jupiter Hospital, Radiation Oncology, Mumbai, India Purpose or Objective High Dose Rate Interstitial Brachytherapy (HDRBT) has an established role in head and neck malignancies and offers good survival rates, however, there are scant data on improved local control (LC) and treatment-related complications in recurrent cases. We present our results in patients with recurrent H&N cancers treated with interstitial HDRBT. Material and Methods Twenty-Five patients with recurrent H&N cancers were treated with HDR interstitial brachytherapy using Iridium 192 as the source between 2009 and 2016. Of these, 75% received radical brachytherapy and 25% received external beam radiation therapy (EBRT) followed by brachytherapy boost. Treatment sites included oral cavity (15/25) and oropharynx (10/25). Median dose was 4.5 Gy twice per day with median total dose with brachytherapy of 40.5Gy in radical and 27Gy for EBRT cases. Patients were followed up and were assessed for survival outcomes and toxicities Results With median follow-up of 25 months, 4 local recurrences were observed within first year of follow up. 2-year local control and overall survival outcomes for the entire group were 75% and 68%, respectively. The local control rate with radical BRT vs BRT as boost following EBRT was found to be significant. (2 year LCR 62% vs 85%; p<0.02). Dosimetric assessment revealed D90 – 4.08Gy, V100 – 94.1%, V150 – 24.7% and V200 – 10.1%. Homogeneity index and Dose Non Uniformity Ratio were 0.71 and 0.39 respectively. Xerostomia, altered taste and dysphagia was seen as major complications commonly grade I and II. Grade III toxicity was only 2%. Pre-treatment volume >85 cc had a negative impact on overall survival (26 months vs 12 month; p = 0.02) and time interval between primary and recurrence more than 15 months had an impact on the local control rate (p < 0.01) Conclusion Results of HDR Interstitial brachytherapy have shown acceptable local control and overall survival rates along with tolerable toxicities and morbidity in recurrent H&N cancers. Prospective clinical trials are warranted using HDR Interstitial Brachytherapy in recurrent H&N cancers

Conclusion In properly selected patients such as those with “de-novo” single lung metastases, SBRT has potential for sustained deferral of systemic treatment. PO-099 Managing recurrent/metastatic head and neck cancer in the real-world: Paclitaxel plus Cetuximab I. Leão 1 , R. Neto 2 , J. Marinho 1 , E. Neto 1 , E. Dias 1 , A. Joaquim 1 1 Centro Hospitalar Vila Nova de Gaia/Espinho, Medical Oncology, Vila Nova de Gaia, Portugal ; 2 Centro Hospitalar Vila Nova de Gaia/Espinho, Intensive Care Unit, Vila Nova de Gaia, Portugal Purpose or Objective Few therapeutic options are available for Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN), which affects 10% of patients diagnosed with SCCHN and up to two thirds of patients with locoregionally advanced disease during the first 2 years of follow-up after a curative intent treatment. Moreover, many of these patients have poor physical condition, often exacerbated by alcohol and tobacco abuse, making them unable to withstand an aggressive treatment approach. Our global aim was to investigate effectiveness and safety of weekly Paclitaxel plus Cetuximab in the treatment of recurrent/metastatic SCCHN. Material and Methods Retrospective cohort study of all patients with SCCHN treated, in our institution, with weekly Paclitaxel (80mg/m 2 ) and Cetuximab (first administration 400mg/m 2 , subsequent administrations 250mg/m 2 ) until September/2018. Descriptive analysis of patients’ characteristics, toxicity profile and response rates. Kaplan-Meier method was used to calculate overall (OS) and progression free (PFS) survival. Results During this period, 27 patients were treated with weekly Paclitaxel plus Cetuximab. Patients were mostly men (25 patients, 93%), with a median age of 54 years (42-72 years) and an ECOG performance status (PS) of 0-1 (67%). The most common primary location of the tumour was the pharynx (52%), followed by oral cavity (33%). This regiment was used as first line palliative chemotherapy in 48% of patients and as second line, after failure of carboplatin plus fluorouracil plus cetuximab, in 33%. The median duration of treatment was 14 weeks (1- 54 weeks). The median follow-up for all patients was 7 months (1-38 months), at the time of the analysis 8 patients (30%) were still alive and 2 patients (7%) were still being treated with Paclitaxel plus Cetuximab. Tumour response was accessed in 19 patients (70%). Disease control rate was 84% (3 complete responses, 5 partial responses, 8 stable disease), with median time to documented tumour response of 2.4 months (0.5-6.4 months) and a median duration of response of 5.0 months (1.2-16.4 months). The median PFS was 4.9 months (95% CI 3.0-6.9 months) and the median OS was 9.4 months (95% CI 6.0-12.8 months). Treatment was discontinued in 25 patients (93%). The three most common reasons for discontinuation were disease progression (36%), worsening of PS (24%) and toxicity (16%). Common clinically relevant adverse events (>G2) were acne-like rash (48%), mucositis (18%), neuropathy (11%) and neutropenia (11%). Conclusion The analysis of real-world data confirms that weekly Paclitaxel plus Cetuximab is a promising regiment for

Poster: Biology, HPV and molecular targeting

PO-101 HPV, tobacco smoking and specific mutations and amplifications in oropharyngeal cancer J. Lilja-Fischer 1 , B. Ulhøi 2 , M. Stougaard 2 , P. Lassen 1 , T. Steniche 2 , J. Alsner 1 , J. Overgaard 1 1 Aarhus University Hospital, Department of Experimental Clinical Oncology, Aarhus, Denmark ; 2 Aarhus University Hospital, Department of Pathology, Aarhus, Denmark