ESTRO 38 Abstract book

S633 ESTRO 38

Otolaryngology, Pordenone, Italy ; 8 S. Martino Hospital, Division of Radiation Oncology, Belluno, Italy ; 9 IRCCS European Institute of Oncology, Scientific Directorate, Milano, Italy Purpose or Objective To evaluate the role of baseline neutrophil-to-lymphocyte ratio (NLR) and other haematological biomarkers and ratios such as neutrophil, lymphocyte, platelet and monocyte count, Lymphocyte to monocyte ratio (LMR) and Platelet to Lymphocyte ratio (PLR) as prognostic markers in locally advanced squamous cell carcinoma of the oropharynx (OPC) treated with definitive chemo- A retrospective analysis of 125 patients, affected with locally advanced OPC and treated between 2010 and 2015 at two tertiary cancer centers in Northen Italy (European Institute of Oncology, Milan and Centro di Riferimento Oncologico, Aviano) was performed. Inclusion criteria were: age>18 years, stage III or IV (TNM 7 th ed.), definitive CxRT. Progression-free survival (PFS) and overall survival (OS) curves were evaluated using the Kaplan-Meier method. Multivariate Cox proportional hazard models were applied to obtain hazard ratios adjusted for other prognostic factors and confounders. Results Median age was 61 (42-77) years and 94 (75.2%) patients were male. HPV status was available in 102 (81.6%) patients and among them 77 (61.6%) pts had HPV/p16+ related OPC. Therapeutic choice consisted in sequential, concurrent and induction followed by concurrent CxRT schedule was delivered to 43 (34.4%), 71 (56.8%) and 11 (8.8%) pts, respectively. Median follow up was 50 months (range 5 - 95 months). A value of NLR≥3 was associated with poorer OS with almost a triple increased risk of death: HR=2.7 (95%CI:1.2, 6.2; p=0.02, adjusted for age, gender, chemotherapy, HPV status and ECOG performance status). Two-years OS was 91% and 81% in pts with NLR<3 and ≥3, respectively (figure 1). No correlation was found between other haematological parameters and prognosis. When restaged with TNM 8 th edition, NLR confirmed prognostic role with increased significance (p=0.03). radiotherapy (CxRT). Material and Methods

Radiation Oncology, Guangzhou, China ; 4 Harbin Medical University Cancer Hospital, Department of Radiation Oncology, Harbin, China ; 5 Cancer Institute Hospital- Chinese Academy of Medical Sciences- Peking Union Medical College, Department of Head and Neck Surgery, Beijing, China Purpose or Objective This study aimed to determine the prevalence, risk factors and prognostic significance of retropharyngeal lymph node (RPLN) in hypopharyngeal squamous cell carcinoma based on magnetic resonance image (MRI). Purpose This study aimed to determine the prevalence, risk factors and prognostic significance of retropharyngeal lymph node (RPLN) in hypopharyngeal squamous cell carcinoma based on magnetic resonance image (MRI). Material and Methods A total of 259 patients diagnosed with hypopharyngeal carcinoma (HPC) from three cancer institutions in China were retrospectively analyzed. The MRIs of all patients were reviewed by by two senior radiologists and the RPLNs were identified. 250 patients (96.5%) were male, with a median age of 57 years old (range: 36-85 years old). Most (85.7%) of them presented advanced diseases (stage III or RPLN metastasis was discovered in 44 patients (17%). Logistic analysis showed that primary tumor site located in posterior pharyngeal wall (PPW), PPW invasion, N2-3 stage, multiple LNs, and Level II/III LN involvement were identified as independent factors associated with RPLN metastasis in HPC. The rates of RPLN metastasis in patients with primary sited located in posterior pharyngeal wall (PW), PW invasion and N2-3 were 37%, 30% and 31%, respectively, compared to those with primary disease located in pyriform sinus, T1-2 and N0-1 were 13%, 10% and 3%, individually. Patients with RPLN metastasis had a significant lower 5-year overall survival rate and 5- year disease-free survival rate than non-RPLN metastasis group (OS: 28% vs. 48%, p=0.001; DFS: 25% vs. 41%, p=0.040). Conclusion metastasis was not uncommon in hypopharyngeal carcinoma, with a prevalence of 17% in this study. Primary tumor located in PW, PW invasion, and cervical LN nodes are risk factors for RPLN metastasis. RPLN metastasis is a poor prognosticator for survival in hypopharyngeal carcinoma. EP-1141 Marginal local failure in nasopharyngeal carcinoma in the era of intensity modulated radiotherapy K. REN 1 , Z. Yin 2 1 Tianjin Meidal University Cancer Hosital & Institute, Department of radiation oncology, Tianjin, China ; 2 Tianjin Medical University Cancer Hospital & Institute, Department of Radiation Oncology, Tianjin, China Purpose or Objective This study makes a detailed analysis of the initial irradiated dose of the recurrent site and local failure patterns after intensity-modulated radiation therapy (IMRT). Based on this analysis, further improvement of delineation recommendations may be made in order to reduce the local recurrence in nasopharyngeal carcinoma (NPC). Material and Methods In total, 253 newly diagnosed non-metastatic NPC patients between Jan. 2012 and Dec. 2014 were retrospectively enrolled. For patients with local failure, the location and extent of local failures were transferred to the pretreatment planning computed tomography (CT) for dosimetric analysis. The dose of radiation received by GTVr (gross tumor volume of recurrence) was calculated and analyzed with dose-volume histogram (DVH). Failures IVa-b). Results

Conclusion In our cohort, a baseline NLR≥3 at treatment initiation represented a negative prognostic marker for OPC treated with definitive CxRT. Our results are in line with literature data and confirmed after re-staging with last TNM. Therefore, this inexpensive and readily available marker could be considered for risk stratification of pts with locally advanced OPC. EP-1140 Retropharyngeal Lymph Node Metastasis in Hypopharyngeal Carcinoma: Analysis from Multi-center Data Z. Yin 1 , X. Zhang 2 , Y. Sun 3 , S. Miao 4 , C. An 5 1 Tianjin Medical University Cancer Institute & Hospital, Radiotherapy, tianjin, China ; 2 Cancer Institute Hospital- Chinese Academy of Medical Sciences- Peking Union Medical College, Head and Neck Surgery, Beijing, China ; 3 Sun Yat-sen University Cancer Center- State Key Laboratory of Oncology in South China, Department of