ICHNO-ECHNO 2022 - Abstract Book

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ICHNO-ECHNO 2022

1 Beaumont Hospital, Department of Head and Neck Surgery, Dublin, Ireland

Purpose or Objective Non-conventional laryngeal malignancies of the larynx constitute less than 5% of all laryngeal malignancies and are often considered to be more aggressive than conventional squamous cell carcinoma (SCC). For many histopathological subtypes, there is a paucity of published data to guide management which is frequently modelled on treatment algorithms for SCC. However, non-conventional laryngeal malignancies often exhibit radically different behaviour, characteristics, and responses to various oncological treatments making this an inadequate approach. We aimed to present our experience of managing such patients and report treatment outcomes. Secondary objectives were risk factor analysis and presentation. Materials and Methods A multicentre retrospective review of non-conventional laryngeal malignancies treated in tertiary head and neck referral centres over the last 23 years was performed. Data on disease stage and treatment received was collected and the primary outcomes were treatment response and recurrence. Overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS) rates were calculated. Results 31 patients with non-conventional laryngeal malignancies were identified including twelve different histopathological subtypes. Sarcomatoid carcinoma was the largest group (n=13). 54.9% of patients received single modality treatment and transoral procedures were the most common operations performed (50%). 3-year OS, DSS and DFS rates were 66.7%, 76.2% and 61.1% respectively. Conclusion Results from this study suggest many non-conventional laryngeal malignancies have oncological outcomes comparable with conventional SCC. Disease stage is frequently a more accurate prognostic indicator than histological subtype. 1 King George's Medical University, Radiotherapy, Lucknow, India; 2 King George's Medical University, Surgical Oncology, Lucknow, India; 3 King George's Medical University, Pathology, Lucknow, India Purpose or Objective Overall treatment time for the multidisciplinary management of locally advanced oral cancers impacts locoregional control and overall survival. Adjuvant radiotherapy should be initiated within 6-7 weeks of surgery, and/or the treatment regimen of surgery and postoperative radiotherapy should be delivered within 11 weeks. This treatment package time is often prolonged in developing countries due to resource constraints or logistical reasons. Materials and Methods In this Phase I/Phase II single-arm clinical trial from an academic university hospital in India, patients with previously untreated, non-metastatic oral cavity squamous cell cancers with indications of adjuvant radiotherapy post-surgery were recruited. Patients were ECOG 0-1 with adequate bone marrow and functional reserves and fit for receiving multimodality treatment. Radiotherapy dose was 50 Gy in 20 daily fractions over four weeks, or 62.5 Gy in 25 daily fractions over five weeks(in case of microscopically positive margins or extranodal extension) delivered on an Elekta Synergy linear accelerator by a three-field technique(parallel opposite pair and low anterior neck fields). Concurrent chemotherapy was not given. The trial is registered with the Clinical Trials Registry-India(CTRI/2021/07/034608). Results Between July and September 2021, twenty-four patients were recruited. Baseline characteristics and pathological details are shown in Table 1. Most patients were males(83%) and had a primary in the oral tongue(42%). All patients underwent wide surgical excision and appropriate reconstruction with neck dissection(MND1:MND2:MND3:SOND:RND – 1:12:8:2:1). The status of resection margins was free:close – 16:8. Most patients were pT3/T4(71%) with a depth of invasion of more than 10mm(58%). Fifty per cent of patients were pN0. Overall, 96% of patients were stage III/IV. Radiotherapy details and acute toxicities are given in Table 2. One patient did not complete radiotherapy and was excluded. Eight patients had a prolongation of planned radiotherapy treatment time(only two patients beyond two days). The median times from surgery to radiotherapy start and completion were 6 and 10 weeks, respectively. No patient had grade 3/4 acute skin or haematological reactions; however, 48% of patients had acute grade 3 mucosal reactions. Median weight loss during radiotherapy was 3.5%. 78% of patients required a nasogastric tube placement, and 61% of patients required admission for supportive care. Common patient-reported outcomes during radiotherapy were pain(70%), altered taste(61%), fatigue(48%), depression(30%), and issues with normal activities(26%) or mobility(9%). PO-0117 Safety data of Phase I/II trial of hypofractionated radiotherapy in resected oral cancers(HYPO-ART) D. Chakrabarti 1 , M. Verma 1 , D. Kukreja 1 , N. Akhtar 2 , S. Rajan 2 , S. Qayoom 3 , V. Kumar 2 , K. Srivastava 1 , R. Gupta 1 , M.L. Bhatt 1