B1: Relapse after radical radiation based treatment for oropharyngeal cancer

Aravindhan Sundaramurthy1,Kirsty MacLennan1,Ioanna Fragkandrea-Nixon1

1Edinburgh Cancer Centre, Edinburgh, UK

Presenting date: Tuesday 3 November
Presenting time: 12.20-13.10

Background

 

Chemo-radiotherapy (CRT) or radiotherapy (RT) remains the standard treatment for oropharyngeal cancers (OPC). The highest risk of recurrence is within the first 2 years and hence the rationale for close follow-up.  We aim to report our patients who relapsed following CRT/RT

Method

We looked at an unselected group of 142 patients treated with CRT or RT for OPC at Edinburgh Cancer Centre (ECC) between Jan’06 to Dec’10. Relapsed patients in this cohort were identified and analyzed

Results

There were 13 relapses [6 local & 7 distant], 9 patients had CRT whilst 4 had RT. All but 1 had locally advanced disease, 1 had neo-adjuvant chemotherapy. The median time to relapse was 10.6 months [Range 8.1 – 16.8]. There were 5 never/ex-smokers and 8 current smokers. The current smokers had an early relapse with median 8.0 months [Range 7.5 – 25] compared to the never /ex-smokers, median time to relapse 13.1 months [Range 8.5 – 50.5].  The median RT duration was 45 days with 9 /13 patients completing radiation ?46 days. Patients who completed radiation ?46 days had a longer median time to relapse compared to >46 days (10.6 months vs. 8.5 months). 1of 6 local relapsed had 1salvage surgery and lived for 9.5 months after surgery.  The median survival for all patients from diagnosis of relapse was 3.7 months [95% CI 1.1 – 7.7]

Conclusion

Though low numbers preclude a significant statistical analysis, the trends suggest early relapse in smokers and those RT >46days. All the relapses happened within the first 2 years of treatment. Though a very close follow-up of 142 patients resulted in a longer survival for only one patient with salvage surgery, the impact of best supportive measures the other relapsed patients benefitted is difficult to measure.  Hence, we recommend continuing the current practice of close follow-up