ESTRO 38 Abstract book

S634 ESTRO 38

1.3 (range: 0.3-6.4) years. In MA, history of surgery for esophageal cancer (HR: 5.55, 95% confidence interval: 1.33-23.33; p = 0.019) and simultaneous radiotherapy for synchronous esophageal cancer (HR: 8.07, 95% confidence interval: 1.93-33.78; p = 0.004) was risk factor for death from aspiration. Conclusion History of surgery for esophageal cancer and simultaneous radiotherapy for synchronous esophageal cancer was predictor for death from aspiration after definitive radiotherapy for hypopharyngeal and supraglottic cancer. EP-1143 Regional nodal failure after primary treatment for differentiated thyroid cancer. G. Fanetti 1 , E. Borsatti 2 , T. Baresic 2 , C. Bampo 2 , A. Esposito 3 , S. Mazzone 3 , C. Mazzon 4 , E. Minatel 1 , A. Revelant 1 , S. Pisu 1 , A. Nappo 1 , E. Casanova Fuga 5 , M. Burello 5 , V. Giacomarra 3 , G. Franchin 1 , C. Gobitti 1 1 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Radiation Oncology, Aviano, Italy ; 2 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Nuclear Medicine, Aviano, Italy ; 3 S. Maria degli Angeli Policlinic Hospital, Division of Otolaryngology, Pordenone, Italy ; 4 S. Maria degli Angeli Policlinic Hospital, Unit of Endocrinology and Metabolic Diseases, Pordenone, Italy ; 5 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Medical Physics, Aviano, Italy Purpose or Objective To evaluate the management and outcome of patients experiencing regional nodal relapse after primary treatment for differentiated thyroid cancer (DTC). Material and Methods Data of all consecutive patients treated at our Institution for DTIC were prospectively collected. All patients (at the time of first diagnosis) underwent surgery for non- metastatic DTC and received adjuvant radioiodine (I-131), if indicated. Regular follow up was performed with Thyroglobulin (Tg) and anti-Tg antibodies level and neck ultrasound (US). In case of suspicious nodes cytological proof of relapse was required and restaging was performed. Treatment of nodal failure was decided on the basis of clinic-radiological features and patient preference. After that, follow up examination with Tg and anti-Tg antibodies level as well as US was performed every 6 months for 5 years, then yearly. Restaging with Total body scan with radioiodine or 18FDG TC/PET was prescribed in case of raise of Tg level and/or positive US. Informed consent for use of anonymized data for scientific purpose was expressed. Results After primary treatment for DTC, 70 out of 1222 patients experienced a first locoregional nodal recurrence after a median time follow up of 21.6 months (range 3-334 months). Patients characteristics are shown in table 1. Treatment consisted of surgical (with or without adjuvant treatment) and non-surgical approach in 65 (93%) and 6 (7%) patients, respectively. Median follow up was 81.8 months (range 4.5-248.7 months) during which we observed a second relapse in 24 (34%) patients. Pattern of failure consisted in locoregional lymph nodes and distant sites in 19 (79%) and 5 (21%) patients, respectively. Five years-Relapse Free (RFS) and Overall Survival (OS) were 68.5% and 97.1%, respectively as shown in figure 1. At the last follow up 56 (80%), 7 (10%), 3 (4%) and 4 (6%) patients were alive with no evident disease, alive with disease, dead of disease and dead for other causes, respectively. Of the 6 patients treated with non-surgical approach (i.e. I-131 in 4 pts, external beam radiotherapy in 1 patient and TSH suppression in 1 case), only 1 patient had a second recurrence and is alive with disease at the last follow up. The remaining 5 patients are alive with no evident disease.

were classified as: “in field” if 95% of GTVr was within the 95% isodose, “marginal” if 20%–95% of GTVr was within the 95% isodose, or “outside” if less than 20% of GTVr was inside the 95% isodose. Results With a median follow-up time of 61.3 months, the 5-year local control was 89%. 21 patients developed local recurrence. Dose conformity with IMRT was excellent, and the recurrence was mainly within 2 years after the first treatment. The dosimetric analysis showed that 14 failures were classified as “in-field”, 1 out-field failure, and only 6 failures as “marginal” failure. Of these 6 marginal failures, two failures occurred in the site of sinus cavernosus, two presented failure in jugular foramens, one was nasal cavity and one in oropharynx wall. Conclusion In the era of intensity-modulated radiotherapy, in-field failures are still the main patterns for local recurrence. However, there were also 6 marginal recurrences, these recurrence patterns may help presenting us some data when delineation the target volume. EP-1142 Death from aspiration after definitive radiotherapy for hypopharyngeal or supraglottic cancer N. Kanayama 1 , T. Ikawa 1 , K. Wada 1 , T. Hirata 1 , M. Morimoto 1 , K. Hayashi 1 , K. Konishi 1 , T. Teshima 1 1 Osaka International Cancer Institute, Radiation Oncology, Osaka, Japan Purpose or Objective The aim of this study is to identify predictors of death from aspiration after definitive radiotherapy for hypopharyngeal or supraglottic cancer, retrospectively. Material and Methods A total of 391 patients were identified from our institutional data base as started definitive radiotherapy for hypopharyngeal and supraglottic cancer between 2006 and 2014. Eighty one patients had a history of malignancy and 76 patients were diagnosed synchronous malignancy. Thirty six patients had a history of surgery for esophageal cancer and 16 patients received simultaneous radiotherapy for synchronous esophageal cancer. The primary site of tumor was hypopharynx in 277 patients and supraglottis in 114. Clinical stages were 0 in 4 patients, I in 28, II in 94, III in 92, IVA in 153, and IVB in 20. Treatment modality were RT alone in 157 patients, CCRT in 222, others in 12. Radiation modality were 3DCRT in 307 patients, IMRT or VMAT in 84. Median total dose was 70 Gy/35 fr. To explore the case of death, cause of death was divided into 5 categories. “cancer under study”, “other malignancy”, “complication of treatment”, “no data”, and “others”. “Others” include aspiration pneumonia and other comorbid illness. Clinical factors (age, performance status, tumor location, clinical T and N stage, treatment modality, radiation modality, history of malignancy, synchrous malignancy, history of surgery for esophageal cancer, simultaneous radiotherapy for synchronous esophageal cancer) were investigated for death from aspiration. Multivariate analysis (MA) was performed by using Cox proportional hazard model and p < 0.05 was considered significant. Results Median follow up for survivors was 6.4 (range: 1.6-12.2) years. The 5-year overall survival and laryngectomy free survival rate were 61.1% and 53.9%. Fifty six patients received total laryngectomy in the follow up. The cause of total laryngectomy were severe dysphagia in 3 patients, laryngeal necrosis in 3, recurrence or second malignancy in 50. In the follow up time, 175 patients died. Eighty six patients (49%) died from “cancer under study”, 46 (26%) from “other malignancy”, 2 (1%) from “complication of treatment”, 9 (5%) from “no data” and 32 (18%) from “others”. Eleven patients died from aspiration. The median survival for patients who died from aspiration was