ICHNO-ECHNO 2022 - Abstract Book

S115

ICHNO-ECHNO 2022

Conclusion A short course of 50 Gy in 20 fractions is appropriate for frail patients, especially when the total tumor volume is less than 27 ml. For bigger tumors, higher doses seem to be required. Age, WHO PS, impaired mobility and cognitive troubles, individually were not good decision factors for a radiotherapy de- intensification. As the gain in survival is limited, abstention of treatment can be a good option in unmotivated pts.

PO-0182 Definitive Radiotherapy for Elderly Patients with Laryngeal Cancer: A Single-Institution Experience

O. Spahiu 1 , B. Shima 1 , A. Qehajaj 1 , G. Hysaj 1 , R. Buci 1 , U. Bitri 1

1 Mother Teresa University Hospital Center, Radiation Therapy Department, Tirana, Albania

Purpose or Objective With the aging population and a rising incidence of squamous cell carcinoma of the larynx, there is an emerging need for developing strategies to treat elderly patients. However, practice patterns in the elderly may not necessarily follow national guidelines. Elderly patients are often subjected to palliative or inadequate treatment for head and neck cancers in spite of being candidates for curative intent therapy. In this study we evaluated the use of radical radiotherapy in larynx cancer for patients over sixty-five years of age to determine morbidity, likelihood of completing therapy, toxicity and oncological outcomes. Materials and Methods We analyzed 46 patients with squamous cell carcinoma of the larynx treated between 2016-2018 at the Department of Radiation Oncology, University Hospital “Mother Teresa” in Albania, with age 65 years or older, who underwent curative radiotherapy and/or surgery. Radiotherapy was delivered by 3DCRT. The dose and fractionation varied between the subsite of disease and the stage. Response to therapy was assessed by clinical, endoscopic assessment for all patients and imaging (CT or MRI) after completing 12 weeks of treatment. The endpoints of the study were the evaluation of the toxicity, the overall survival (OS) and the disease-free survival (DFS). Results The median age of patients was 72 years (range 65-84). Thirty-nine (85%) patients had an ECOG performance status 1, while the remaining 7 (15%) had a performance status of 2. The subsite involved was supraglottic in 8 (17%), glottic in 36 (78%), and subglottic in 2 (5%) patients. All patients (100%) completed radiotherapy. The most common toxicities were mucositis, skin reactions or dysphagia. All patients had at least minor (grade I/II) toxicities. Grade III toxicities were seen in 4 (9%) of patients. No grade IV reactions or treatment related deaths occurred. When a univariate analysis was performed for determinants of major toxicities with age range, performance status, number of co-morbidities or TNM stage, no determinants were statistically significant. Patients with a worse performance status and advanced stage (III/IV) were at higher risk of grade III toxicity. Follow-up was for a median of 24 months (range 9-36 months). The 2 years OS for all four stages was 100%. The 2 years DFS for stages I, II, III and IV was 100%, 97%, 85% and 66%, respectively. Conclusion Patients over sixty-five years well-tolerate radical radiotherapy treatment of laryngeal cancer. In spite of minor toxicities, all patients completed treatment and had good oncological outcomes. Patients with stage III/IV unfit for concomitant chemotherapy administration treated with radiotherapy alone had a good disease free survival. Curative intent therapy should not be withheld from elderly patients on the basis of age.

PO-0183 Impact of nivolumab in elderly patients with advanced head and neck squamous cell carcinoma.

C. Becherini 1 , M. Banini 1 , I. Desideri 1 , M. Mariotti 1 , V. Salvestrini 1 , L. Caprara 1 , V. Scotti 2 , B. Agresti 3 , P. Garlatti 3 , L. Livi 1 , P. Bonomo 1 1 AOU Careggi - University of Florence, Radiotherapy Unit, Florence, Italy; 2 AOU Careggi , Radiotherapy Unit, Florence, Italy; 3 AOU Careggi, Radiotherapy Unit, Florence, Italy