ESTRO 36 Abstract Book

S592 ESTRO 36 2017 _______________________________________________________________________________________________

we reviewed medical records of 71 patients with locally advanced laryngeal cancer (T3-4 or N+) treated at the Radiation Oncology Department, National Cancer Institute, Cairo University, Egypt, during the period from 2007 to 2013 inclusively. Prognostic factors, treatment modalities, and their effect on loco-regional control (LRC) and overall survival (OS) were studied. Results mean age was 61 years. Smoking history was present in 94% of patients. Squamous cell carcinoma was the most common pathological type (98%). Glottic carcinoma represent 31%, supraglottic carcinoma represent 60.5%, while transglottic carcinomas represent 8.5% of patients. Prescribed radiotherapy dose was 70Gy/35 fractions/7 weeks. Combined chemoradiotherpy was used in 72%, while radiotherapy alone was used in 28% of patients. Concurrent chemotherapy regimens used were weekly Cisplatin (93%), weekly Carboplatin (5%), and Cisplatin D1,22,43 (2%). Twenty five patients received induction chemotherapy (IC); mostly Docetaxel/Cisplatin/5-FU (TPF) protocol (17 patients). The majority of patients (64%) achieved complete remission (CR). Locoregional failure was reported in 4 patients, and salvage surgery was done for those patients. The 3-year LRC and OS rates were 73% and 46.3% respectively. The only adverse prognostic factor affecting OS was poorly differentiated tumors (P=0.05). Other factors which did not significantly affect LRC or OS were pretreatment Hemoglobin (P=0.14), T stage (P=0.52), nodal stage (P=0.10), radiotherapy machine used (P=0.09), received dose of RT (P=0.14), dose per fraction (P=0.68), gaps during RT (P=0.10), use of IC (P=0.32), and time interval between IC and RT (P=0.47). Laryngectomy free survival (LFS) rate at 2 and 3 year were 42% and 34% respectively. Conclusion Concomitant chemoradiotherapy is an effective modality for organ preservation in advanced laryngeal cancer with LFS 42% which can be further improved by better selection of patients. The poorly differentiated tumors significantly affect OS. EP-1085 Comparative study of outcomes and toxicities in conventional 2DRT vs IMRT in locally advanced HNSCC K. Periasamy 1 , P. Baskaran Shanmuga 2 , S. Sambasivam 1 , T.P. Soni 1 , N. Patni 1 , G.K. Singh 2 , J. Kaur 2 , A. Gupta 2 , K.T. Bhowmik 2 1 Bhagwan Mahavir Cancer Hospital and Research Center, Radiation Oncology, Jaipur, India 2 Safdarjung Hospital, Radiation Oncology, New Delhi, India Purpose or Objective To compare conventional 2DRT with intensity modulated radiation therapy (IMRT) in locally advanced head-neck squamous cell carcinoma (HNSCC) patients treated with curative-intent chemoradiation (CRT) with respect to treatment outcome and toxicities. Material and Methods This bi-institutional study is a retrospective comparative analysis of patients with biopsy-proven locally advanced HNSCC (stage III-IV) who were treated either with conventional 2DRT or IMRT to a radiation dose of 66-70 Gy with concurrent chemotherapy. In this study the treatment response to CRT, treatment related acute and chronic toxicities, disease status and overall survival at 2 years were compared between conventional 2DRT and IMRT. Treatment related toxicities were reported using physician rated RTOG acute and late toxicity criteria. Results 58 patients who were treated with conventional 2DRT and 56 patients who were treated with IMRT for locally advanced HNSCC between 2012 and 2014 were chosen for comparative analysis. The 2DRT arm consisted of 45% of stage III and 55% of stage IV patients whereas the IMRT arm

had 27% and 73% of them respectively. In the 2DRT arm 53% and 47% had grade 2 and 3 acute mucositis where as in the IMRT arm it was 80% and 5% respectively. This difference reached statistical significance (p<0.001). But, acute skin toxicity was only marginally higher in the 2DRT arm than the IMRT arm. In the 2DRT arm 84% had grade 2 and 3 acute xerostomia while in the IMRT arm it was 45% and this difference reached statistical significance (p=0.004). Likewise, the difference remained statistically significant (p=0.01) with chronic xerostomia evaluated at 1 year post treatment with an incidence of 76% in the 2DRT arm and 38% in the IMRT arm. It was observed that the treatment break due to acute radiation reactions were more in the 2DRT arm (16%) than in the IMRT arm (9%), however this did not reach statistical significance. However, these two modalities showed no significant differences in response to CRT and loco- regional control or survival at 2 years.

Conclusion IMRT significantly reduces the incidence and severity of acute mucositis and acute and chronic xerostomia when compared with conventional 2DRT in the treatment of locally advanced HNSCC. However, IMRT did not show superiority over 2DRT with respect to response to CRT, locoregional control and survival at 2 years. EP-1086 Health status and phisical activity in head and neck cancer survivors A. Matías-Pérez 1 , G. Gallego-Herreros 1 , B. G. Díaz de Tudanca 1 , P. Soria-Carreras 1 , A. Nieto-Palacios 1 , A. Rodríguez-Gutierrez 1 , L.A. Pérez-Romasanta 1 1 Hospital Universitario de Salamanca, Radiation Oncology Department, Salamanca, Spain

Purpose or Objective