ESTRO 38 Abstract book

S370 ESTRO 38

to assess the prognostic value of indicators calculated on the basis of initial hematology parameters: neutrophil–to- lymphocyte ratio (NLR), lymphocyte–to-monocyte ratio (LMR), platelet–to-lymphocyte ratio (PLR), leukocyte count (WBC) and modified Glasgow Prognostic Score (mGPS) in patients with HNC after Radiotherapy alone or combined with chemotherapy. Material and Methods Between 01/2009 and 08/2013 191 patients with squamous cell carcinoma of nasopharynx (4%), oropharynx (39%), hypopharynx (13%), larynx (36%) or oral cavity (8%) were treated with curative intent with RT alone or combined with platinum-based chemotherapy. There were 47% patients with T1/2 and 53% with T3/4 of primary tumor stage and 31% and 69% of patients with N0 and N+ nodal stage disease, respectively. Complete blood counts (CBC), C-reactive protein (CRP) and albumin were estimated in blood or serum before the treatment. Patient mGPS was scored: as 0 when there were normal levels of albumin (≥35 g/l) and CRP (≤10 mg/l), as 1 when CRP was elevated (>10 mg/l) but albumin was normal and as 2 when CRP was elevated (>10 mg/l) and albumin was decreased (<35 g/l). Treatment outcome was defined as complete remission (CR - no evidence of disease) or treatment failure (TF - residual disease or recurrence). Results Median follow-up was 40 months. There was CR, and TF respectively in 69% and 31%. Second primary tumor or distant metastasis were observed in 12% of patients. Patients had significantly longer disease free-survival (DFS) when counts of WBC (< 6,77 G/l) and NLR (<2,01) were low (p=.002 and p=.03), respectively. Significantly longer overall survival (OS) was found for patients with low counts of WBC (<6,77 G/l) (p=.001), NLR (<2,01) (p=.01), or mGPS score (=0) (p=.04). No correlation was observed between LMR or PLR and DFS and OS. Conclusion In patients with head and neck cancer after radiotherapy alone or combined with chemotherapy high initial levels of NLR and WBC seems to predict worse treatment results. Low levels of inflammatory indicators like WBC, neutrophils count, mGPS, and high lymphocytes count may by associated with longer OS in this group in patients. PO-0722 Carbon ion radiotherapy for adenoid cystic carcinoma in the head-and-neck A. Hasegawa 1,2,3,4 , B. Vischioni 3 , M. Bonora 3 , S. Ronchi 3 , S. Molinelli 3 , M. Ciocca 3 , A. Facoetti 3 , F. Valvo 3 , P. Fossati 5 , B. Alicja Jereczek 4 , M. Koto 2 , T. Kamada 2 , J. Mizoe 1 , R. Orecchia 3,4 1 Osaka Heavy Ion Therapy Center, Radiation oncology, Osaka, Japan ; 2 National Institutes of Radiological Sciences Hospital, Radiotherapy, Chiba, Japan ; 3 National Center for Oncological Hadrontherapy CNAO, Radiation Oncology, Pavia, Italy ; 4 European Institute of Oncology IEO, Radiotherapy, Milan, Italy ; 5 MedAustron, Radiotherapy, Wiener Neustad, Austria Purpose or Objective The National Institutes of Radiological Sciences (NIRS)* reported the clinical results of carbon ion radiotherapy (CIRT) for various types of head and neck malignancies, including acute and late morbidities, local control, and survival rates. In clinical protocols of the National Center for Oncological Hadrontherapy (CNAO), Fossati P et al ** demonstrated a practical method to translate NIRS RBE- weighted doses and the prescription doses of CIRT were applied based on this method. This study aims to evaluate the optimum dose of CIRT for adenoid cystic carcinoma (ACC) in the head-and-neck at CNAO compared to NIRS. Material and Methods Between December 2013 and June 2018, a total of 146 patients with adenoid cystic carcinoma of the head-and- neck were treated with carbon ion radiotherapy at CNAO. The prescribed tumor doses were 65.6 or 68.8 Gy (RBE) in

PO-0720 Tumor volume/metabolism improve prognostication of anatomy-based stage for nasopharyngeal cancer? Y. Jeong 1 , K.K. Lee 1 , S.R. Moon 1 , S.Y. Noh 2 , J. Kwak 2 , S. Lee 2 1 Wonkwang University Hospital- Wonkwang University School of Medicine, Radiation Oncology, Iksan, Korea Republic of ; 2 Asan Medical Center- University of Ulsan College of Medicine, Radiation Oncology, Seoul, Korea Republic of Purpose or Objective We evaluated the prognostic value of the 8 th edition of the AJCC/UICC staging system and investigated whether tumor volume/metabolic information refined the prognostication of current anatomy based staging system in nasopharyngeal cancer. Material and Methods The 133 patients with nasopharyngeal cancer who were staged with MRI and treated with IMRT between 2004 and 2013 were retrospectively reviewed, and all patients were re-staged according to the 8 th edition of the AJCC/UICC staging system. The survival rates were estimated from the date of the start of radiotherapy, and univariate and multivariate analyses were performed to evaluate prognostic value of the 8 th edition of the AJCC/UICC staging system and other factors including gross tumor volume and maximum standardized uptake value of primary tumor (GTV-T and SUV-T). Results The follow-up period was median 63 months (range, 7.2- 155.8 months), and the 5-year OS was 80.8%. The stage group as well as age, pathology, GTV-T, and SUV-T were significant prognostic factors for OS in univariate analysis. In multivariate analysis, stage group (stage I-II vs. III-IVA) was the only significant prognostic factor (HR, 11.062, p=0.017), but, OS rates were not significantly different between stage I and II (5-year OS, 100% vs. 96.2%, p=0.347), and between stage III and IVA (5-year OS, 80.1% vs. 71.7%, p=0.673). Although SUV-T and GTV-T were not significant prognostic factors for OS in multivariate analysis, the incorporation of SUV-T and GTV-T into stage group improved prognostication of stage group. The OS rates were significantly different between stage I-II, III-IV (SUV-T ≤ 16), and III-IV (SUV-T > 16) (5-year OS, 97.2% vs. 78% vs. 53.8%, p < 0.001), and between stage I, II-IV (GTV- T ≤ 33ml), II-IV (GTV-T > 33ml) (5-year OS, 100% vs. 87.3% vs. 66.7%, p=0.021). Conclusion The current anatomy based staging system have limitations on prognostication for nasopharyngeal cancer even though that was based on the most accurate assessment of tumor extent by MRI. The tumor volume/metabolic information seems to improve the prognostication of current anatomy based staging system, and further studies are needed to confirm its clinical significance. PO-0721 Prognostic Value of Inflammatory Markers in Patients with Head and Neck Cancer. J. Mrochem-Kwarciak 1 , T. Rutkowski 2 , A. Wygoda 2 , A. Chmura 1 , K. Składowski 2 1 Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Analytics and Clinical Biochemistry Department, Gliwice, Poland ; 2 Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, I Radiation and Clinical Oncology Department, Gliwice, Poland Purpose or Objective Inflammation is generally accompanied cancer disease. Evaluation of the inflammatory biomarkers in the treatment of head and neck cancer (HNC) patients is of potential prognostic value. The aim of present study was