ESTRO 2023 - Abstract Book


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ESTRO 2023

This real-world study suggests that CVA is associated with age, obesity and radiation dose for NPC patients who receive concurrent chemoradiotherapy in TMRT era. Further prospective study and long-term follow-up are warranted to clarify the relevance between cerebrovascular accidents and concurrent chemoradiotherapy in nasopharyngeal carcinoma.

PO-1228 The accuracy of staging head and neck MRI versus histopathology in patients with laryngeal cancer

I. Mohamad 1 , S. Koro 1 , A. Taqash 2 , A. Almousa 1 , E. Mayta 3 , F. Ajlouni 4 , A. Al-Ibraheem 5 , H. Haddad 6 , F. Abuhijla 1,1 , R. Abuhijlih 1 , T. Hussein 1 , W. Al-Gargaz 3 , A. Hosni 7 1 King Hussein Cancer Center, Radiation Oncology Department, Amman, Jordan; 2 King Hussein Cancer Center, Biostatistics Departement, Amman, Jordan; 3 King Hussein Cancer Center, Surgical Oncology Department, Amman, Jordan; 4 King Hussein Cancer Center, Radiology, Amman, Jordan; 5 King Hussein Cancer Center, Nuclear Medicine Department, Amman, Jordan; 6 King Hussein Cancer Center, Pathology Departemnt, Amman, Jordan; 7 Princess Margaret Cancer Centre, University Health Network, University of Toronto, Radiation Medicine Program, Toronto, Canada Purpose or Objective Purpose/Objective: To evaluated the diagnostic value of head and neck MRI (HN-MRI) in accurate pre-operative estimation of tumor invasion to laryngeal subsites in patients with laryngeal cancer. Materials and Methods Methods: Between 2008 and 2021, all patients with primary or recurrent laryngeal cancers who underwent staging HN-MRI and treated with total laryngectomy were evaluated. The preoperative HN-MRI and histopathological findings were independently reviewed by experienced HN-MRI radiologists and dedicated HN pathologists to assess the accuracy of tumor extensions of laryngeal subsites. Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of diagnostic HN-MRI were estimated for all laryngeal subsites. The overall diagnostic accuracy was classified into: excellent (>90%), very good (>80-90%), good (>70-80%), sufficient (>60-70%), bad (>50-60%), not useful ( ≤ 50%) (Simundic et al, EJIFCC 2009). Results Results: A total of 137 patients were identified. 98(71.5%) had overlapping laryngeal tumors, 32(23.4%) had glottic tumors, and 7(5.1%) had supraglottis tumors. For clinical vs pathological T-category; T4a disease was diagnosed in 116 (84.7%) vs 109(79.6%) patients, T3 in 17 (12.4%) vs 23(16.8%), T2 in 2 (1.5%) vs 3(2.2%), T1 in 2 (1.5%) vs 0(0%), and T0 in 0(0%) vs 1(1.5%) patients. The MRI overall diagnostic accuracy of prediction of tenor extensions was excellent for base of tongue (91%) and arytenoid (92%), very good for vocal cord (82%) and posterior commissure (87%), good for preeiglottis space (72%) and cricoid cartilage (76%), and sufficient for inner thyroid cortex (65%), and subglottis (68%) subsites extension. For regional lymph node involvement MRI showed high rates of false negative findings with overall accuracy of 62% (sensitivity 57.1%, specificity 69.8%). Conclusion Conclusion: HN-MRI provides acceptable accuracy results for predicting histopathogical findings of tumor extension, and it is an appealing imaging modality for primary radiation therapy of laryngeal cancer, particularly in the era of MR-linac adaptive radiotherapy.

PO-1229 Definitive radiotherapy in T1 glottic carcinoma: long-term results and quality of life

R. Benlloch Rodriguez 1 , J. Romero Fernández 1 , M. Hernández Miguel 1 , B. Gil Haro 1 , M. López Valcárcel 1 , S. Córdoba Largo 1 , C. De la Fuente Alonso 1 , U.A. Corro Verde 1 , L. Paisán Palacio 1 , S. Santana Jiménez 1 , P. Sarrión Rubio de la Torre 1 , S. Pérez Mata 1 , J.F. Martínez Paredes 1 , M.Á. Ruiz Rodríguez 1 , J. Velasco Jiménez 1 , I. Zapata Paz 1 , M.I. García Berrocal 1 , M.R. Magallón Sebastián 1

1 Puerta de Hierro University Hospital, Radiation Oncology, Madrid, Spain

Purpose or Objective To evaluate long-term outcomes, quality of life (QoL) and voice and risk of second tumors on patients with early-glottic carcinoma. Materials and Methods A total of 118 patients with T1N0M0 squamous-cell glottic carcinoma treated between 2000-2021 were retrospectively analyzed. Mean age: 63 years; males/females: 105/13; T1a/T1b: 95/23. Treatment: radical radiotherapy, mean dose: 70Gy (2Gy/fraction) over a mean period of 50 days. In 37 patients, we prospectively evaluated (EORTC)–QLQ-C30, (EORTC)- Head&Neck-35 module and voice handicap index (VHI-30) questionnaires. Statistics: Kaplan-Meier and Chi-square test. Results Median follow-up 112 months. 10-year actuarial OS was 70%. 10-year actuarial LC, regional control and metastasis-free survival were 80%, 95% and 96% respectively. Twenty patients had recurrent disease. Overall treatment time was not prognostic factor. Mean score (MS) for VHI-30 was 13.51, which is considered as a minimal amount of handicap. Functional scores were over 94 and symptoms scores below 14. Global-health status/QoL scale was 83.30. In H&N-35 the worse scores were dry mouth and thick saliva (MS 21.83 and 20.71 respectively). Most patients have no problems in swallowing, open mouth, pain, or social contact (MS of 4.04, 0, 3.35 and 3.06, respectively). Twenty-three patients (19%) had second tumor, meanly lung cancer (14p.). Twenty-year probability of second lung cancer was 24%.

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