ESTRO 37 Abstract book

S897

ESTRO 37

Conclusion PT is feasible and safe treatment for elderly pts with intracranical and skull base tumors. Longer follow-up is necessary to assess definitive efficacy. EP-1666 Elderly patients with head and neck cancer and the benefit of curative-intent treatment M. Núñez Fernández 1 , A. Folgar Torres 2 , E. Mur Restoy 1 , M. Galdeano Rubio 2 , M. Bonet Beltrán 3 , J.M. Solé Monné 1 1 Consorci Sanitari de Terrassa. Hospital de Terrassa, Radiation Oncology Department, Terrassa, Spain 2 Consorci Sanitari de Terrassa. Hospital Sant Joan de Dèu de Manresa, Radiation Oncology Department, Manresa, Spain 3 Hospital Universitari Sant Joan de Reus, Radiation Oncology Department, Reus, Spain Purpose or Objective To assess the tolerability, feasibility and response of radical or postoperative radiation therapy in elderly patients diagnosed with head and neck cancer. Material and Methods Retrospective analysis of patients 70 years or older, diagnosed with head and neck squamous cell carcinoma (HNSCC) who were treated in a single institution between May 2013 and December 2016 with radiotherapy (RT), chemo-radiotherapy (CRT) or cetuximab-radiotherapy (bioRT) in radical or postoperative setting. Acute toxicity was assessed by the Common Terminology Criteria for Adverse Events version 4.0 scale and the overall survival (OS) were compared using the log-rank test. Results 81 patients with a mean age of 78 years were included with a median follow-up of 15 months. The most frequent primary site were larynx (44%), followed by oral cavity (17%) and salivary glands (11%). 75% were stage III or IV M0 as defined by American Joint Committee on Cancer criteria version 7. 53% were treated with radical intent and 47% postoperatively. 65% received RT, 19% CRT and 16% bioRT. The most frequent total dose for patients treated with radical intent was 69,96-70 Gy/33-35 daily fractions (79%) and 60-66 Gy/30-33 daily fractions (80%) in the postoperative setting. The 75% of patients were treated with 3D-conformal RT and the image-guided RT were cone-beam-CT with or without Hexapod system in 57% of patients. There were no G4 or G5 toxicity. The most frequent acute toxicities were G1-2 and G3 toxicities were oral mucositis (17%), dermatitis (9%), dysphagia (6%), skin pain (4%), oral pain (3%) and cheilitis (1%). At last follow-up, 55 patients (68%) were alive and 26 (32%) died. In terms of disease control, 83% of patients had no evidence or stable disease, however 16% had progression. In subgroup of patients treated with radical intent, 74% had a complete response and 9% had a stable disease. The median OS was 34,5 months (95% CI: 29,5-39,5 months) for the entire group; 36,1 (95% CI: 28.9-43,2 months) and 30,8 (95% CI: 24,9-36,6 months) in postoperative and radical setting. In subgroup of patients treated with RT alone, CRT or bioRT the median OS was 34,1 months (95% CI: 28,1-40,1 months), 34,8 (95% CI: 26,1-43,5 months) and 23,8 (95% CI: 16,9-30,7 months) respectively. Conclusion Treatment with radical or postoperative intent in elderly patients with HNSCC should be considered for its acceptable acute toxicity profile and good early results.

EP-1667 Radiotherapy for elderly laryngeal carcinoma patients: A Single Centre Experience from Turkey F. Sert 1 , I. Kaya 2 , K. Oztürk 2 , M. Esassolak 1 1 Ege University, Department of Radiation Oncology, Izmir, Turkey 2 Ege University, Department of Otolaryngology, Izmir, Turkey Purpose or Objective Elderly patients are potentially sensitive to cancer treatments due to comorbidities and/or geriatric syndromes. Larynx cancer is the most common head and neck cancer in Turkey. Elderly patients aged ≥70 years account for 6-15% of all laryngeal carcinomas. The purpose of this study is to assess efficacy and toxicity of definitive and postoperative radiotherapy (RT) for laryngeal carcinoma patients aged≥70 years. Material and Methods Between December 2006 and January 2016, a retrospective data evaluation was performed. Inclusion criteria were: age ≥70 years at the time of diagnosis, histologically proven laryngeal epidermoid carcinoma, treated with RT or RT and concomitantly KT with definitive or postoperative purposes. Exclusion criteria were: Stage I patients, the previous RT history, and metastases at the time of diagnosis. Inclusion date was defined due to the acceptance of Cetuximab therapy in our clinical protocol. Totally 66 (4 female, 62 male) patients were evaluated for this analyses. Median age was 74 (range, 70-86) year. Karnofsky Performance Status was ≥80% in 56 (84,8%) patients. Total RT dose was 70 Gy and 60-66 Gy for definitive and postoperative settings with 2 Gy per fraction, respectively. Concomitant chemotherapy (CT) agent was chosen according to stage and performance status of the patients. Cetuximab was used for the patients with proven renal problem. All acute and late term toxicities were evaluated with RTOG Median follow-up time was 29,5 (range, 4-126) months. Using TNM classification, tumors were stage IIA (18,2%), stage IIIA (31,8%), stage IIIB (3%) and stage IVA (47%). The purpose of RT was definitive for 33 (50%) patients and postoperative for 33 (50%) patients. Concomitant CT was used in 21 (31%) patients and 9 (42%) of those were cetuximab and other 12(58%) were cisplatin. RT was interrupted in 94% of patients but finished within 6-7 week in all patients. Cisplatin dose reduction was needed in 20% patients but cetuximab was used with suggested protocol. Three-year local relapse free(LRF), metastases free(MF) and overall survival(OS) rates for all patients were 74%, 84%, and 48%, respectively. For concomitant CT group, 3-y LRF, MF and OS rates were 55%, 74%, and 36%, respectively. Only 26 (39,4%) patients died due to disease specific problems, other 18 (27,2%) patients died with unknown problems. In toxicity evaluation, there was not seen any grade 3-4 adverse effect. Rush due to cetuximab was seen nearly all included patients but treatment break was need for only 1 patient due to rush. Conclusion Radiotherapy seem to be an effective therapy in elderly population either alone or concomitant with CT in definitive and postoperative setting. On the other hand, comorbid diseases should be managed carefully in follow- up period. scales. Results