Abstract Book

S640

ESTRO 37

Material and Methods The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 4131 patients with squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma, undifferentiated carcinoma, or adenoid cystic carcinoma in nasal cavity and nasal sinus between 2004 and 2014. Chi-square analysis was used to evaluate distribution of patient and tumor related factors within treatment groups. The Kaplan- Meier method was utilized to calculate overall survival. Log-rank method was used in univariate analysis and Cox- regression model was used to perform the multi-covariate analysis. All statistical tests were two-sided. Results In univariate analysis, T stage, N stage, pathology type, pathology grade and primary site (nasal cavity or nasal sinus) were prognostic factors (p<0.05 for all). Receiving radiotherapy or surgery predicted a better prognosis (p<0.05 for two). Chemotherapy was predictive of a worsen prognosis (p=0.03). In multivariate analysis, chemotherapy, radiotherapy, surgery, T stage, N stage, pathology type, pathology grade and primary site were all independent prognostic factors (p<0.05 for all).However, chemotherapy was marginally predictive of a better prognosis(p=0.049). Subgroup analyses were performed. For 882 patients treated with radiotherapy and no surgery, patients with T3 or N2 stage benefited from chemotherapy (5y-OS: 40.8% vs 17.8%, p=0.007; 28.4% vs 15.2%, p=0.036), while patients with T2 or N0 stage who received chemotherapy showed even worse OS (5y-OS: 27.4% vs 64.0%, p=0.013; 35.0% vs 88.0%, p=0.007). For 1190 patients who received surgery only, patients with N0 stage who received chemotherapy showed worse OS than those who received no chemotherapy (5y-OS: 63.1% vs 74.1%, p=0.016). For 1615 patients who received both radiotherapy and surgery, chemotherapy did harm to patients with T1 or N0 stage (5y-OS: 47.1% vs 60.0%, p=0.005; 63.1% vs 74.1%, p=0.000). Conclusion Chemotherapy was marginally predictive of a better prognosis for patients with nasal cavity and nasal sinus cancer. T3 or N2 patients treated with radiotherapy and no surgery were most likely to benefit from chemotherapy. Otherwise patients may not benefit from chemotherapy and were even harmed. Further randomize controlled trail is warranted in this patient group. EP-1137 Chemoradiotherapy in head and neck cancer: an option for radical treatment. Our experience A.V. Navarro Bergadá 1 , J. Lorca Chapa 2 , V. Saiz Monfort 3 , A. Bermell Carrión 3 , A. Pastor Del Campo 4 , J. Jornet Fayos 4 , G. Barrios 5 , F. Tarazona 6 , M. Albert Antequera 1 , C. Domingo Boluda 1 , M. López Muñoz 1 , J. Monroy Antón 1 , A. Soler Rodríguez 1 , M. Soler Tortosa 1 1 Hospital Universitario de la Ribera, Radiation Oncology, Alzira, Spain 2 Hospital Universitario de la Ribera, Medical Oncology, Alzira, Spain 3 Hospital Universitario de la Ribera, ORL, Alzira, Spain 4 Hospital Universitario de la Ribera, Radiology, Alzira, Spain 5 Hospital Universitario de la Ribera, Maxillofacial Surgery, Alzira, Spain 6 Hospital Universitario de la Ribera, Geriatrics, Alzira, Spain Purpose or Objective The management of head and neck (H&N) cancer with strategy of organ preservation using chemoradiotherapy (CT-RT) allows the avoidance of mutilating surgeries, as well as treatments with radical intention for initially inoperable tumours. In our hospital, if possible, we have offered alternative treatment to our patients for many years. Many of them choose conservative therapy. We review our experience in CT-RT and, as the main purpose

of this work, we describe the overall survival at 2, 3 and 5 years with this strategy in our patients. Material and Methods This is a retrospective study with 167 patients recruited between September, 2007 and December, 2015. All of them diagnosed with H&N cancer (for locations, see Figure 1) who received radical treatment with different CT-RT schemes: 145 (87%) were concomitant treatments, 98 cases (58.7%) with CDDP every 3 weeks, 27 cases (16.2 %) weekly carboplatin, and 20 (12 %) with weekly cetuximab (loading dose 1 week before CT-RT). 22 cases (13%) received neoadjuvant chemotherapy (NCT) before CT-RT. The NCT with TPF scheme was used in 19 patients (11.4%). There were 2 cases with Al-Sarraf NCT scheme, and 1 with CDDP. The radiotherapy technic was 3D in 96 (57.5 %) patients, and IMRT in 71 (42.5 %). We performed PET-CT for planning in 49 (29.3%) cases. 75 patients (45%) had CT-RT with standard fractionation, with an average dose (Dm) of 69.2 Gy. 85 cases (51%) were schemes with hypofractionated accelerated (2.1-2.3 Gy/fraction) simultaneous integrated boost (SIB), Dm of 67 Gy. 7 remaining cases were treated with concomitant boost schemes.

Results By gender, we studied 144 (86.2 %) males and 23 (13.8%) females. The average age was 60 (age range: 16-84). By stage, 12 (7.2 %) were stage II, 33 (19.8%) stage III and 122 (73 %) stage IV. All the patients completed the treatment. The average length of treatment with CT-RT was 7.4 weeks for the standard fractionation and 6.3 weeks for the hypofractionated schemes. The overall survival at 2, 3 and 5 years was 59.1%, 54.2% and 35.1%, respectively. In Figure 2, we present a table with the status of the patients, grouped by tumour sites, at the end of the study.

Conclusion CT-RT is an option in the treatment of advanced H&N cancer. It can avoid mutilating surgeries with acceptable results in advanced stages. These treatments might be a choice for radical management in patients with an inoperable disease. EP-1138 Laser Therapy for radiochemotherapy- induced mucositis in HNC: a randomised, phase III trial