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713 poster Thyroid gland medullar cancer-outcome of combined treatment and prognostic factors
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with node metastases extracapsular extension was noted. Only 12 pts (29%) after partial resection and radiotherapy did not require tracheostomy. Emergency tracheostomy was done before surgery in 29 pts (15%). The risk of postoperative recurrence was established according to modified Peters' criteria. In 118 of pts (60%) risk of local recurrence was low (0-2), in 59 (30%) moderate (3-5) and in 20 (10%) high (>5). In 53 of pts (51%) risk of nodal recurrence was low, in 33 (32%) moderate and in 13 (13%) high. Results: 5-year actuarial LC, DFS and OS were 88%, 68% and 73%, respectively. Along with increasing clinical stage DFS decreases from 79% in Stage I to 62% in stage IV. 5year DFS was 33% and 25% lower in the case of macroscopic or microscopic non-radicalism, respectively comparing to pts after radical resections. 5-year DFS was 29% lower in pts with extracapsular extension. 5-year LC was 83% after partial resection comparing to 90% after total resection. 5-year DFS in pts with pretreatment tracheostomy was 47% comparing to 71% in pts with tracheostomy performed during surgery. The most significant influence on treatment results was observed for particular groups of risk recurrence: 5-year LC and DFSwas 93% and 76% respectively for pts with low risk of local recurrence, 86% and 57% for moderate risk and 63% and 42% for high risk. Similar, highly significant correlation was observed for groups of risk of nodal recurrence: 5-year LC and DFS was 94% and 88% respectively for pts with low risk of local recurrence, 88% and 88% for moderate risk and 79% and 42% for high risk. Conclusions: Most important negative prognostic factors influencing combined modality treatment are: macro- or microscopical surgical non-radicalism, presence of node metastases, extracapsular extension and emergency tracheostomy. The most important influence on efficacy of combinetl modality treatment has the degree of risk recurrence established according to modified Peters' scale 712 poster Combined treatment of head and neck in children
K. Ficek ~, S. Blamek ~, W. Madziara 2, R. Tarnawski~, L. Miszczyk ~ ~Oncology Center Institute, Department of Radiotherapy, Gliwice, Poland 2Institute of Paediatric Oncology, Surgery Department, Katowice, Poland Introduction: Head and neck tumours rarely occur in children but a wide variety of neoplasm can arise in that Iocalisation. Multimodality treatment based on surgery, chemotherapy and radiotherapy improved the outcome on this group. Purpose: The purpose of this study was to evaluate the results of combined treatment in children with head and neck tumours. Material: The analysis was based on 19 patients treated in Department of Radiotherapy from 1993 to 2003. Children were 4 to 18 Years old (13yr. med.). There were 12 cases (63%) children with rhabdomyosarcoma and 7 (37%) nasopharyngeal carcinomas. 12 patients underwent surgery and then were treated with chemotherapy and postoperative radiotherapy. Second group (7 cases) were treated only with radiotherapy and chemotherapy. Most of patients were irradiated with the conventional schedule, only three patients with nasopharyngeal carcinoma were given hyperfractionated radiotherapy.
$309
Results: The overall survival was 84%. Four patients died, one from metastatic disease, three had local relapse, two patients with disseminated nasopharyngeal carcinoma are still alive. Only one patient with orbit RMS developed a postirradiation cataract. Others did not show ant late side effects or developmental disturbances. Conclusions: Combined treatment in head and neck tumours is an effective schedule in children. Radiotherapy can be successful treatment in non operable cases and as post-operative treatment. 713 poster Thyroid gland medullar cancer-outcome of combined treatment and prognostic factors
V. Stankovic 1, N. Borojevic 1, R. Dzodic2, I. Golubicic ~ 1Institute for oncology and radiology of Serbia, Radiotherapy, Belgrade, Serbia and Montenegro 2Institute for oncology and radiology of Serbia, Surgery, Belgrade, Serbia and Montenegro Introduction: Aim of the study was to evaluate results of combined treatment of thyroid gland meduliar cancer/ TGMC/determining probability of total survival, probability of survival without local recurrence and to investigate influence of prognostic parameters on treatment outcome. Methods: Non-randomized, retrospective, prospective study, including 36 patients with sporadic form of TGMC was conducted at Institute for oncology and radiology of Serbia. Median age of the group was 49,5 years/27-75years/. Incidence of both sexes was even/18;18/.27 patients were in third clinical stage and nine ones in the second clinical stage. After initial surgical treatment, all the patients were treated with postoperative transcutaneous irradiation therapy. The radiation therapy was conducted on megavoltage machines, with conventional regime of fractioning and total tumor dose of 55-65Gy. Median follow-up of the group was 37,75months. Results: probability of total 5-year survival for the group of 36 patients with sporadic form of TGMC, treated with surgery and postoperative irradiation therapy was 62, 61% and ofl0year survival 23, 48%. Probability of 5-year survival without local recurrence for the same group was 59, 54%. Here was no local recurrence after 5 years. Analysing influence of prognostic factors on treatment outcome, statistically significant difference was found regarding local recurrence in relation to disease clinical stage and time passed from operation to beginning of irradiation therapy. Cox's multivariant analysis showed statistical significance only for clinical stage of disease. Conclusions: Analysing obtained results of combined treatment we concluded that post-operative irradiation therapy did not contribute total survival, but, it was important in maintaining local control. Good treatment results were obtained owing to radical surgical treatment. 714 poster Intravenous administration of amifostine in bolus prior to radiotherapy in head and neck cancer
L. Gutierrez Bayard, C. Salas Buzon, P. Roman Rodriguez Puerta de/Mar Hospital, Radiotherapy, Cadiz, Spain Purpose: To present and defend the safety and tolerability advantage in administering amifostine in a rapid, 30 second intravenous in bolus administration of amifostine, versus the traditional 28 minute administration of this drug. In our experience, the traditional 28 minutes administration of amifostine has so severe negative side effects that 6.2% of
with node metastases extracapsular extension was noted. Only 12 pts (29%) after partial resection and radiotherapy did not require tracheostomy. Emergency tracheostomy was done before surgery in 29 pts (15%). The risk of postoperative recurrence was established according to modified Peters' criteria. In 118 of pts (60%) risk of local recurrence was low (0-2), in 59 (30%) moderate (3-5) and in 20 (10%) high (>5). In 53 of pts (51%) risk of nodal recurrence was low, in 33 (32%) moderate and in 13 (13%) high. Results: 5-year actuarial LC, DFS and OS were 88%, 68% and 73%, respectively. Along with increasing clinical stage DFS decreases from 79% in Stage I to 62% in stage IV. 5year DFS was 33% and 25% lower in the case of macroscopic or microscopic non-radicalism, respectively comparing to pts after radical resections. 5-year DFS was 29% lower in pts with extracapsular extension. 5-year LC was 83% after partial resection comparing to 90% after total resection. 5-year DFS in pts with pretreatment tracheostomy was 47% comparing to 71% in pts with tracheostomy performed during surgery. The most significant influence on treatment results was observed for particular groups of risk recurrence: 5-year LC and DFSwas 93% and 76% respectively for pts with low risk of local recurrence, 86% and 57% for moderate risk and 63% and 42% for high risk. Similar, highly significant correlation was observed for groups of risk of nodal recurrence: 5-year LC and DFS was 94% and 88% respectively for pts with low risk of local recurrence, 88% and 88% for moderate risk and 79% and 42% for high risk. Conclusions: Most important negative prognostic factors influencing combined modality treatment are: macro- or microscopical surgical non-radicalism, presence of node metastases, extracapsular extension and emergency tracheostomy. The most important influence on efficacy of combinetl modality treatment has the degree of risk recurrence established according to modified Peters' scale 712 poster Combined treatment of head and neck in children
K. Ficek ~, S. Blamek ~, W. Madziara 2, R. Tarnawski~, L. Miszczyk ~ ~Oncology Center Institute, Department of Radiotherapy, Gliwice, Poland 2Institute of Paediatric Oncology, Surgery Department, Katowice, Poland Introduction: Head and neck tumours rarely occur in children but a wide variety of neoplasm can arise in that Iocalisation. Multimodality treatment based on surgery, chemotherapy and radiotherapy improved the outcome on this group. Purpose: The purpose of this study was to evaluate the results of combined treatment in children with head and neck tumours. Material: The analysis was based on 19 patients treated in Department of Radiotherapy from 1993 to 2003. Children were 4 to 18 Years old (13yr. med.). There were 12 cases (63%) children with rhabdomyosarcoma and 7 (37%) nasopharyngeal carcinomas. 12 patients underwent surgery and then were treated with chemotherapy and postoperative radiotherapy. Second group (7 cases) were treated only with radiotherapy and chemotherapy. Most of patients were irradiated with the conventional schedule, only three patients with nasopharyngeal carcinoma were given hyperfractionated radiotherapy.
$309
Results: The overall survival was 84%. Four patients died, one from metastatic disease, three had local relapse, two patients with disseminated nasopharyngeal carcinoma are still alive. Only one patient with orbit RMS developed a postirradiation cataract. Others did not show ant late side effects or developmental disturbances. Conclusions: Combined treatment in head and neck tumours is an effective schedule in children. Radiotherapy can be successful treatment in non operable cases and as post-operative treatment. 713 poster Thyroid gland medullar cancer-outcome of combined treatment and prognostic factors
V. Stankovic 1, N. Borojevic 1, R. Dzodic2, I. Golubicic ~ 1Institute for oncology and radiology of Serbia, Radiotherapy, Belgrade, Serbia and Montenegro 2Institute for oncology and radiology of Serbia, Surgery, Belgrade, Serbia and Montenegro Introduction: Aim of the study was to evaluate results of combined treatment of thyroid gland meduliar cancer/ TGMC/determining probability of total survival, probability of survival without local recurrence and to investigate influence of prognostic parameters on treatment outcome. Methods: Non-randomized, retrospective, prospective study, including 36 patients with sporadic form of TGMC was conducted at Institute for oncology and radiology of Serbia. Median age of the group was 49,5 years/27-75years/. Incidence of both sexes was even/18;18/.27 patients were in third clinical stage and nine ones in the second clinical stage. After initial surgical treatment, all the patients were treated with postoperative transcutaneous irradiation therapy. The radiation therapy was conducted on megavoltage machines, with conventional regime of fractioning and total tumor dose of 55-65Gy. Median follow-up of the group was 37,75months. Results: probability of total 5-year survival for the group of 36 patients with sporadic form of TGMC, treated with surgery and postoperative irradiation therapy was 62, 61% and ofl0year survival 23, 48%. Probability of 5-year survival without local recurrence for the same group was 59, 54%. Here was no local recurrence after 5 years. Analysing influence of prognostic factors on treatment outcome, statistically significant difference was found regarding local recurrence in relation to disease clinical stage and time passed from operation to beginning of irradiation therapy. Cox's multivariant analysis showed statistical significance only for clinical stage of disease. Conclusions: Analysing obtained results of combined treatment we concluded that post-operative irradiation therapy did not contribute total survival, but, it was important in maintaining local control. Good treatment results were obtained owing to radical surgical treatment. 714 poster Intravenous administration of amifostine in bolus prior to radiotherapy in head and neck cancer
L. Gutierrez Bayard, C. Salas Buzon, P. Roman Rodriguez Puerta de/Mar Hospital, Radiotherapy, Cadiz, Spain Purpose: To present and defend the safety and tolerability advantage in administering amifostine in a rapid, 30 second intravenous in bolus administration of amifostine, versus the traditional 28 minute administration of this drug. In our experience, the traditional 28 minutes administration of amifostine has so severe negative side effects that 6.2% of