ESTRO 36 Abstract Book

S601 ESTRO 36 _______________________________________________________________________________________________

Material and Methods We analized the incidence of local side -effects during adyuvant radiotherapy treatment in 24 locally advanced laryngeal cancer patients who underwent laser microsurgery. In terms of TNM classification 14 patients were T3 stage and 10 patients T4a stage. In 20 patients chemotherapy was associated to radiation (83%) The incidence of acute local side -effects during Radiotherapy treatment were analized according to the following factors: Laryngeal mucositis grade (RTOG scale); Swallowing dysfunction meassured by Visual Analogue Pain Scale; Radiation treatment duration and early discontinuation of Radiation treatment. All patients were treated with IMRT technique Results We observed an increased acute toxicity in this group of patients compared to those who underwent chemoradiation alone or associated to larynguectomy. Ten patients presented grade 3 or 4 mucositis during the treatment (41%) The grade of swallowing dysfunction were up to 5 in all patients and up to 8 in 6 (20%) meassured in a 1 to 10 pain scale. The median treatment duration were 45 days, that reveals an increase compared to conventional cohort (48%) Five patients required definitive early suspensión of treatment (20%). Eight patients underwent percutaneous gastrostomy when the weight-loss was above 15%. Three patients underwent tracheotomy due to severe glottic stenosis produced by edema (12%). Conclusion In our experience Transoral Laser Microsurgery with adyuvant Radiotherapy in advanced laryngeal cancer EP-1095 Combined induction chemotherapy and radiotherapy in locally advanced nasopharyngeal carcinoma. A. Gevorkov 1 , A. Boyko 1 , L. Bolotina 2 , A. Kornietskaya 2 , T. Deshkina 2 1 Moscow Research Gerzen Oncology Institut, Radiation oncology, Moscow, Russian Federation Purpose or Objective This prospective trial was conducted to evaluate the efficacy and toxicity in previously untreated patients with stage III-IV nasopharyngeal carcinoma who received an induction chemotherapy followed by radiotherapy. Material and Methods From January 2004 to December 2010, 50 patients with T2-4N2-3M0 squamous cell carcinoma of the nasopharynx were treated with three or six cycles of docetaxel 75 mg/m2 (1-st day), cisplatin 75 mg/m2 (1-st day), doxorubicin 45 mg/m2 (1-st day) (50 patients) followed by radiotherapy using the conventional time/dose schedule. Results The response rate to chemotherapy was 88% (48% complete response [CR]; 40% partial response [PR]), and the overall CR rate after radiotherapy was 92%. With a median follow-up period of 90 months, the 3-year survival rate was 63,6% and 3-year loco-regional control was 45,8%. The 5-year survival rate was 58% and 5-year loco-regional control was 42%. Treatment was tolerated, but with significant acute or chronic toxic effects and radiotherapy treatment gaps. patients has increased side-effects. We do not recommend this association 2 Moscow Research Gerzen Oncology Institut, Chemotherapy, Moscow, Russian Federation

Conclusion The results of this study demonstrate that docetaxel, cisplatin and doxorubicin followed by radiotherapy can induce a durable remission in a high proportion of patients with poor-prognosis stage III-IV nasopharyngeal carcinoma. Treatment may be associated with severe toxicity and unplanned irradiation delays. EP-1096 Using DIR to study patterns of loco-regional failure in patients with head and neck cancer Y. Zheng 1 , D.J. Noble 2 , R. Jena 2 , N. Burnet 2 1 Addenbrooke's Hospital- Cambridge University Hospitals NHS Foundation Trust, School of Clinical Medicine, Cambridge, United Kingdom 2 Addenbrooke's Hospital- Cambridge University Hospitals NHS Foundation Trust, Department of Oncology- Cancer Research UK VoxTox Research Group, Cambridge, United Kingdom Purpose or Objective Using deformable image registration (DIR), we examined patterns of loco-regional failure in patients who had undergone IMRT with daily image guidance for head and neck squamous cell carcinoma (HNSCC). Material and Methods A database of HNSCC patients recruited to the Cancer Research UK VoxTox study between March 2013 and January 2016 was reviewed. All patients had been treated on TomoTherapy units, according to local protocol. Inclusion criteria for this sub-study were: full details of treatment protocol (RT and chemo) available, adequate follow-up, confirmed residual or loco-regionally relapsed disease, and diagnostic quality imaging of this disease (including MRI, PET/CT, CT) available for review. This gave a final cohort of 12. Imaging confirming relapse or residual disease was uploaded to virtual simulation software (Prosoma 3.3), where an in-built DIR package was used to fuse these images with the planning CT and treatment dose-cube. Residual/relapsed disease was contoured on the relapse imaging, named rGTV, and the volume of this structure recorded. Contours describing the 95% isodose of 65Gy, 60Gy, 55Gy and 54Gy where relevant were generated. For each case, the proportion of rGTV covered by these isodoses and the treatment PTV and CTVs were recorded (labelled ‘V’). Relapses were classified according to the 95% isodose of prescription dose contour: ‘in-field’ V > 75%, ‘marginal’ V – 25-75%, ‘out of field’ V < 25%. Results