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 93

Istanbul, Turkey; 5 Ankara Yildirim Beyazit University, Radiation Oncology, Ankara, Turkey; 6 Bezmialem Foundation University, Radiation Oncology, Istanbul, Turkey Purpose or Objective In head and neck cancer patients with postoperative positive surgical margins and extracapsular extension, adjuvant concurrent chemoradiotherapy (CCRT) is standard approach (1), but it is controversial in patients older than 70 years due to side effect concerns. Although Woody et al.showed that CCRT contributed to overall survival also in patients aged 70 years and older (2), no statistically significant difference was found in the study of Giacalone et al. (3). The aim of our study was to evaluate the treatment results of 70 years and older patients with squamous cell head and neck cancer treated with postoperative radiotherapy +/- chemotherapy. Material and Methods The radiotherapy +/-chemotherapy results and the factors affecting survival were evaluated retrospectively in 86 patients aged 70 years and older with squamous cell head and neck cancer in six different centers between 2009- 2017. Results The median age was 75 (70-92), female / male ratio was 18 (20%) / 68 (80%). 51% of the patients had a history of smoking, 62% had a comorbidity and 21% had a median loss of 3 (2-8) kg. The most common tumor localization was larynx (n = 38, 44%), and the postoperative surgical margin in 16 (19%), extracapsular extension in 15 (17%), and perineural invasion in 14 (16%) was positive. The most common clinical and pathological stage was cT3N0 (n = 19, 22%), and pT4N0 (n = 11, 13%). kN0 / pN (+) ratio was 33/16; kN (+) / pN0 ratio was 27/9. The median number of metastatic pLN was 1 (1-17). RT was started on postoperative median 40 (24-127) days. Median RT dose was 60 (44-70) Gy. Only 16 (19%) patients were hospitalized during RT period. IMRT / VMAT ratio was 25/21. Concurrent chemotherapy was performed in 16 (18%) patients, 13 of whom were Cisplatin. While only half of the patients with concurrent chemotherapy indications were able to receive CT, all patients completed the planned RT scheme. Median follow-up was 22 (6-104) months. 8 recurrence (5 local, 2 regional, 1 local-regional) and 2 distant metastases (1 lung + liver, 1 bone) were detected. Median, 1-year and 2-year overall survival was 20 (6-104) months, 74% and 62%, and disease-free survival was 22 (6-104) months, 87% and 78%. In univariate analysis, non-laryngeal tumor localization and the presence of pT3-4 tumor were found to be negative factors for disease-free survival (p <0.05). Conclusion Tumor location and stage of patients aged 70 years and older were found to be factors affecting survival. The age should not be decisive in the decision of adjuvant treatment of elderly head and neck cancer patients aged 70 years and older. References: 1.Cooper JS, et al. Int J RadiatOncolBiolPhys. 2012; 84(5):1198-205. 2. Woody NM, et al. Int J RadiatOncolBiolPhys. 2017; 98(4):784-792. 3. Giacalone NJ, et al. Laryngoscope. 2017 Aug 21. doi: 10.1002/lary.26798. PO-176 Management of head and neck non-melanoma skin cancer in the elderly H.J. Kim 1 , S.Y. Song 1 , J. Baek 1 , J.Y. Roh 1 , H.J. Park 1

1 Gil Medical Center- Gachon University College of Medicine, Department of Dermatology, Incheon, Korea Republic of Purpose or Objective This study was to determine the clinical and surgical characteristics of elderly patients with skin cancers compared to younger patients. Material and Methods All cases of non-melanoma skin cancers on the head and neck (basal cell carcinoma [BCC], squamous cell carcinoma [SCC], SCC in situ [SCCIS], in a referral center for the last 2 years were retrospectively reviewed. Information on the epidemiologic characteristics, the type, location, size, and choice treatment modalities of the lesions were collected. Results There were 51 cases (49 patients) in the elderly group (age ≥80), and 106 cases (105 patients) in the younger group (age <80). Female predominance was noted in the elderly than the younger (81.6% female vs. 61.0%, p=0.016). BCC was the most common cancer (74.5%) in both groups (43.2% vs 74.5%), while the incidence of SCC and SCCIS was significantly increased in the elderly (p <0.001). There was more involvement of cheek (41.2% vs. 19.8%) with less involvement of nose (15.7% vs. 31.1%) in the elderly compared to the younger patients. The elderly tended to not opt for surgery (58.8% vs. 78.1%) and preferred medical treatments (topical ingenol mebutate or imiquimod), refused further treatments, or lost for follow- ups (p=0.001). Although the Charlson Comorbidity Index Score (CCIS) was higher and the lesion size of each type of skin cancer was larger for the elderly patients, the difference was not statistically significant. Among those who underwent surgery, complication was rare for both groups and the incidence was not significantly different between the two groups. Conclusion In our study population, the elderly were more likely to choose non-surgical treatments or no further treatment over surgery. However, skin cancer lesions were not significantly advanced at presentation in the elderly compared to the younger patients, and surgical resection was a safe and effective treatment option regardless of age with careful perioperative monitoring and appropriate control of comorbid illness. PO-177 Different definitive Radiotherapy approaches in Indian elderly Head and Neck Cancer patients K. Sazzad Manir 1 , S. Basu 1 , S. Guha 1 , M. Goswami 1 , G.U. Gunasekaran 1 , S. Das 1 1 Medical Cancer Hospital, Department of Radiotherapy, Rangapani-Siliguri, India Purpose or Objective Treatment of Squamous Cell Carcinoma of Head & Neck Cancer (SQCCHNC) in elderly age group is challenging. Role of either curative ChTRT or accelerated fractionation (ACRT) in this subgroup is not clearly defined. Material and Methods Between July 2015 to December 2017, we treated 61 elderly (>70 years) SQCCHNC patients (excluding T1/T2N0M0 Ca Glottis). 18 patients had been excluded from analysis for < 6 months follow-up. 3 patients were excluded as they did not complete RT. We retrospectively analysed 40 patients who were treated with definitive RT [ChTRT (18)/ACRT(10)/ RT only (12) ] . Clinical outcomes