ESTRO 36 Abstract Book

S584 ESTRO 36 2017 _______________________________________________________________________________________________

October 1, 2013 and March 31, 2016. The LE of NPC patients was obtained using linear extrapolation of a logit- transformed curve and was adjusted by the corresponding QOL function to calculate the QALE and SWPS. Results The mean age at diagnosis of the 875 non-metastatic NPC patients was 50.7 years. The median duration from the beginning of radiotherapy to the date of completing questionnaires was 6.5 months (range, 0-154.9 months). The average LE and QALE were estimated to be 15.7 years and 14.5 quality-adjusted life years (QALYs) for NPC patients and 29.5 years and 29.5 QALYs for the reference population, respectively. On average, the lifelong duration of pain and painkiller use were 5.7 years and 1.8 years. The lifelong duration of any impairment of swallowing, smell and taste were 14.6 years, 8.5 years and 6.9 years, respectively. The life long duration of dry mouth was 13.3 years. Furthermore, the lifelong duration of tube-feeding was only 1.5 months. Conclusion This study offers more understandable information than the 5 year survival outcomes when communicating with patients or the general population regarding cancer risk and the impact of treatments on the quality of life. In the future, evaluating the robustness of comparative assessments for the outcome of NPC patients undergoing different treatment protocols will be possible. EP-1070 Concurrent chemoradiation versus upfront surgery for clinical T3-4 hypopharynx and larynx cancer G.S. Yoo 1 , D. Oh 1 , J.M. Noh 1 , Y.C. Ahn 1 , C.H. Baek 2 , Y.I. Son 2 , H.S. Jeong 2 , J.M. Sun 3 , M.J. Ahn 3 , K. Park 3 1 Samsung Medical Center, Department of Radiation Oncology, Seoul, Korea Republic of 2 Samsung Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, Korea Republic of 3 Samsung Medical Center, Department of Medicine- Division of Hematology-Oncology, Seoul, Korea Republic of Purpose or Objective The optimal treatment regimen for advanced T stage hypopharynx and larynx cancer is controversial. In this study, we aimed to compare the oncologic outcomes and functional larynx-preservation (FLP) rates for advanced clinical T stage (T3-4) hypopharynx and larynx cancer between definitive concurrent chemoradiotherapy (CCRT) and upfront surgery with or without adjuvant therapy. Material and Methods We reviewed the medical records of 148 patients with clinical T3-4 hypopharynx or larynx cancer who were treated between January 2005 and May 2013. Primary treatment was determined in the multidisciplinary team. In the CCRT group (N=63), 7 (11.1%) patients received induction chemotherapy, followed by definitive CCRT. Fifty-five (87.3%) patients were treated with 3- dimensional conformal radiation therapy (RT), and 8 (12.7%) patients with intensity-modulated RT. The median RT dose in the CCRT group was 70 Gy (range, 15.4 to 72 Gy). In the surgery group (N=76), TL was performed in 47 patients (61.8%), partial laryngectomy in 28 patients (36.8%), and partial pharyngectomy only in 1 (1.3%). Fifty- nine (77.6%) patients received adjuvant RT and 5 (6.6%) patients received adjuvant CCRT. Median RT dose in the surgery group was 60 Gy (range, 52 to 70 Gy). Results Median follow-up duration was 46 months (range, 0 to 172 months). In total cohort, the 5-year locoregional control (LRC), progression-free survival (PFS), and overall survival (OS) rates were 68.7%, 56.5%, and 64.1%, respectively. Between the CCRT and surgery group, there was significant difference in LRC rate (CCRT vs. surgery, 57.5% vs. 78.9% at 5 years, p=0.014). The ultimate LRC rate

including salvage treatment, however, was not different significantly between the groups (73.2 vs. 81.7% at 5 years, p=0.209). There was no significant difference in PFS (p=0.175), and OS rates (p=0.965) between the groups. On the multivariate analysis, treatment modality was not independent factor for oncologic outcomes.

The 5-year FLP rate was higher significantly in CCRT group (75.4% vs. 35.5%, p<0.001). The laryngoesophageal dysfunction-free survival rate in CCRT group was 56.9%. On the multivariate analysis, treatment modality was independent factor in FLP with hazard ratio of CCRT group as 0.261 (95% confidential interval with 0.139-0.488, p<0.001). Conclusion Under the multidisciplinary approach, there were no significant differences in oncologic outcomes between the CCRT and surgery groups, while CCRT gave more opportunity to preserve the laryngeal function. EP-1071 Organ-sparing SBRT in reirradiation of head and neck cancer: efficacy, toxicity, and quality of life I. Zhang 1 , G. Gill 1 , M. Marrero 1 , A. Sharma 1 , A. Riegel 1 , D. Paul 2 , J. Knisely 1 , S. Teckie 1 , M. Ghaly 1 1 North Shore LIJ Health System, Radiation Medicine, New Hyde Park, USA 2 North Shore LIJ Health System, Medical Oncology, New Hyde Park, USA Purpose or Objective To present a retrospective analysis of the efficacy, toxicity, and quality of life (QOL) of patients treated with organ-at-risk (OAR)-sparing salvage stereotactic body radiotherapy (SBRT) in previously-irradiated head and neck cancer. Material and Methods From November 2012 to July 2015, 60 patients with in- field recurrence of head and neck cancer underwent reirradiation with OAR-sparing SBRT at our institution. OARs were defined as critical structures that had approached their radiation tolerances after prior irradiation and had a high potential to impair QOL if damaged with re-irradiation. Intact tumors were prescribed 40 Gy while 35 Gy was prescribed for post- operative treatments. Doses previously received by the OARs were estimated by deformably registering the prior treatment plan onto the new simulation CT to more accurately delineate dose distributions (Figure 1: Prior plan overlying the new planning CT without (top) and with (bottom) deformable registration). Dose constraints for SBRT were calculated with a biological equivalent dose (BED) using an alpha/beta ratio of 3 to reduce the risk of