ESTRO 36 Abstract Book

S596 ESTRO 36 _______________________________________________________________________________________________

Widłak 3 1 Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology III Dept., Department of Radiotherapy, Gliwice, Poland 2 Maria Sklodowska-Curie Memorial Cancer Center and Institute of oncology iii dept., i radiation and clinical oncology department, gliwice, polan 3 maria sklodowska-curie memorial cancer center and institute of oncology iii dept., center for translational research and molecular biology of cancer, gliwice, poland 4 maria sklodowska-curie memorial cancer center and institute of oncology iii dept., tumor pathology department, gliwice, poland 5 maria sklodowska-curie memorial cancer center and institute of oncology iii dept., department of epidemiology and silesia cancer registry, gliwice, poland Purpose or Objective Despite of confirmed prognostic importance of human papilloma virus (HPV) for patients with head and neck cancer (HNC) such data based on Polish population is scarce. The aim of the study was to estimate the ratio of HPV related tumors in patients with HNC and to evaluate the prognostic role of HPV in patients with pharynx or larynx cancer treated with radiotherapy alone (RT) or in combination with chemotherapy (CHRT) in the Cancer Center-Institute in Gliwice, Poland between 2012 and 2014. Material and Methods 322 consecutive patients with HNC (nasopharyngeal cancer (NPC) 25 (7.8%), oropharyngeal cancer (OPC) 125 (38.8%), hypopharyngeal cancer (HPC) 36 (11,2%), laryngeal cancer (LXC) 132 (41%), cancer of unknown primary (FPI) 4 (1,2%)) treated radically with RT (121/38%) or CHRT (201/62%) have been included. HPV etiology has been confirmed basing on tissue material and/or circulating-free DNA HPV. The ratio of HPV-related tumor has been estimated in all group and in OPC patients. Patients with OPC HPV-related (HPV+) and HPV-not related (HPV-) were compared acc. to other prognostic factors. Three-years local (LC), nodal (NC) control survival rates and disease-free (DFS), distant metastases-free (DMFS) and overall survival (OS) rates were compared for patients with OPC (HPV+) and OPC (HPV-). Results Median follow up was 36 months. HPV-related tumors have been confirmed in 72 (23%) patients, in 3 (4.2%), 58 (80,5%), 1 (1,4%), 9 (12,5%), 1 (1,4%) of patients with NPC, OPC, HPC, LXC and FPI respectively. In OPC patients these with HPV+ and HPV- did not differ by sex and the age. OPC (HPV-) were smokers more often (p=0,0007). T stage in both groups was similar, but N stage was significantly higher in (HPV+) (p=0.03). Patients with OPC (HPV+) had significantly higher 3-year LC (91% v 72%, p=0,006), NC (90% v 70%, p=0,008), DFS (85% v 63%, p=0,008) and OS (78% vs 66%, p=0,17). 3-year DMFS was the same in both groups (93% v 94%, p=0.6). In multivariate analysis HPV appeared to be an independent factor influencing OS ratio. Conclusion HPV-related tumors in Polish patients with HNC could be found in a similar percentage like in other countries, reaching almost half of patients with OPC. Polish patients with OPC (HPV+) are not so young but do not smoke and present higher advanced nodal stage. Our findings confirm that HPV is a strong, independent and beneficial prognostic factor in Polish patients with OPC. EP-1084 Laryngeal preservation using chemo- radiotherapy, single institution experience from Egypt. A. Al Nagmy 1 , T. Shouman 1 , A. Hassouna 1 , M. Gaber 2 1 Cairo University- National Cancer Institute, Radiation

Oncology Department, Cairo, Egypt 2 Cairo University- Faculty of medicine, Clinical Oncology Department, Cairo, Egypt Purpose or Objective to evaluate organ preservation by radical radiotherapy ± chemotherapy (CT) in locally advanced laryngeal cancer Material and Methods 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