- Email: [email protected]
P11. Sentinel node
Pan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings Poster Abstracts Oral AbstractsPoster List
14
Panel discussions and symposia abstracts / Oral Oncology Supplement 3 (2009) 11–23
P11. Sentinel node F. Civantos
P14. TBC J. Boyle
University of Miami, USA
Memorial Slaon – Kettering Cancer Centre, USA
[Abstract not available at time of print.]
[Abstract not available at time of print.]
doi:10.1016/j.oos.2009.06.024
doi:10.1016/j.oos.2009.06.027
P12. Image guidance J. Irish
P15. TBC J. Vermorken
University Health Network, Canada
University Hospital Antwerp, Belgium
[Abstract not available at time of print.]
[Abstract not available at time of print.]
doi:10.1016/j.oos.2009.06.025
doi:10.1016/j.oos.2009.06.028
Panel discussion 4: Impact of HPV on management of oral and oropharyngeal cancer
PD16. TBC P. Rhys Evans Royal Marsden Hospital and Institute of Cancer Research, UK
PD13. Impact of HPV on the management of oral and oropharyngeal cancer – Radiotherapy aspects B. O’Sullivan Princess Margaret Hospital, Canada University of Toronto, Canada Most patients with HPV positive oropharyngeal cancer comprise a distinct clinico-pathological group and have more favorable outcome compared to differentiated keratinizing squamous cell carcinoma linked to smoking and alcohol. This is not apparent for true oral cavity cancers. Because of the favorable outcome in HPV-associated oropharynx cancers it is appropriate to consider strategies to reduce treatment intensity. Unfortunately our current state of knowledge is insufficient to permit firm recommendations. For example HPV-positive patients who are smokers may retain the adverse profile of more traditional head and neck cancer; in addition HPV-associated oropharyngeal cancers may demonstrate rare behaviors that are atypical for traditional disease (e.g. brain metastases or multifocal disease that renders planning problematic notwithstanding high radiotherapy sensitivity). It is evident that we do not yet understand this disease completely. In addition scrutiny of randomized data show that HPV-positive patients, especially involving radiotherapy, still benefit significantly from treatment intensification. This emphasizes that it is still premature to provide clear guidelines since less intensive treatment may be inferior. Well designed prospective clinical trials are required that address these patients specifically and that include stopping rules to address the potential risk of undertreatment. Correlative biology must also be emphasized for trials that address reduction in intensity. Thus several trials with HPV positive and negative patients that compare chemosparing strategies (e.g. EGFR inhibition and radiotherapy) vs concurrent chemoradiotherapy are active or in design and may provide clues to intensity reduction when the HPV-associated subset is analyzed separately. Examples of these trials will be discussed.
doi:10.1016/j.oos.2009.06.026
[Abstract not available at time of print.] doi:10.1016/j.oos.2009.06.029
Panel discussion 5: Treatment morbidites and survivorship PD17. Treatment morbidities and survivorship J.J. Sciubba The Milton J. Dance Head and Neck Center at The Greater Baltimore Medical Center, USA A substantial side effect profile and numerous toxicities are related to the successful management of oral and head and neck cancer. Such treatment-related side effects may impact overall rates of survival as well as the quality of life in the survivor of head and neck cancer. This brief presentation will identify and outline well known treatment options as well as newer therapies and their role in relation to production of side effects and how patients manage late onset side effects of these treatment modalities. The somatic considerations include including eating, swallowing and speech dysfunction,thyroid dysfunction in the irradiated neck, neurologic dysfunction related to nasopharyngeal cancer treatment and overall diminishment of functional capacity, as well as mood disorders and decreased quality of survivorship. The spectrum of late treatment effects also will demonstrate functional compromise related to xerostomia, speech alterations and residual pain. The emerging role of epidermal growth factor receptor inhibitor implementation in head and neck cancer is associated with cutaneous and ocular mucosal morbidity. Incorporation of treatment strategies which secondarily involve the need for placement of foreign bodies into the airway, gastrostomy tubes and intravenous cannulae further complicate management with potential negative impact on survival. doi:10.1016/j.oos.2009.06.030
14
Panel discussions and symposia abstracts / Oral Oncology Supplement 3 (2009) 11–23
P11. Sentinel node F. Civantos
P14. TBC J. Boyle
University of Miami, USA
Memorial Slaon – Kettering Cancer Centre, USA
[Abstract not available at time of print.]
[Abstract not available at time of print.]
doi:10.1016/j.oos.2009.06.024
doi:10.1016/j.oos.2009.06.027
P12. Image guidance J. Irish
P15. TBC J. Vermorken
University Health Network, Canada
University Hospital Antwerp, Belgium
[Abstract not available at time of print.]
[Abstract not available at time of print.]
doi:10.1016/j.oos.2009.06.025
doi:10.1016/j.oos.2009.06.028
Panel discussion 4: Impact of HPV on management of oral and oropharyngeal cancer
PD16. TBC P. Rhys Evans Royal Marsden Hospital and Institute of Cancer Research, UK
PD13. Impact of HPV on the management of oral and oropharyngeal cancer – Radiotherapy aspects B. O’Sullivan Princess Margaret Hospital, Canada University of Toronto, Canada Most patients with HPV positive oropharyngeal cancer comprise a distinct clinico-pathological group and have more favorable outcome compared to differentiated keratinizing squamous cell carcinoma linked to smoking and alcohol. This is not apparent for true oral cavity cancers. Because of the favorable outcome in HPV-associated oropharynx cancers it is appropriate to consider strategies to reduce treatment intensity. Unfortunately our current state of knowledge is insufficient to permit firm recommendations. For example HPV-positive patients who are smokers may retain the adverse profile of more traditional head and neck cancer; in addition HPV-associated oropharyngeal cancers may demonstrate rare behaviors that are atypical for traditional disease (e.g. brain metastases or multifocal disease that renders planning problematic notwithstanding high radiotherapy sensitivity). It is evident that we do not yet understand this disease completely. In addition scrutiny of randomized data show that HPV-positive patients, especially involving radiotherapy, still benefit significantly from treatment intensification. This emphasizes that it is still premature to provide clear guidelines since less intensive treatment may be inferior. Well designed prospective clinical trials are required that address these patients specifically and that include stopping rules to address the potential risk of undertreatment. Correlative biology must also be emphasized for trials that address reduction in intensity. Thus several trials with HPV positive and negative patients that compare chemosparing strategies (e.g. EGFR inhibition and radiotherapy) vs concurrent chemoradiotherapy are active or in design and may provide clues to intensity reduction when the HPV-associated subset is analyzed separately. Examples of these trials will be discussed.
doi:10.1016/j.oos.2009.06.026
[Abstract not available at time of print.] doi:10.1016/j.oos.2009.06.029
Panel discussion 5: Treatment morbidites and survivorship PD17. Treatment morbidities and survivorship J.J. Sciubba The Milton J. Dance Head and Neck Center at The Greater Baltimore Medical Center, USA A substantial side effect profile and numerous toxicities are related to the successful management of oral and head and neck cancer. Such treatment-related side effects may impact overall rates of survival as well as the quality of life in the survivor of head and neck cancer. This brief presentation will identify and outline well known treatment options as well as newer therapies and their role in relation to production of side effects and how patients manage late onset side effects of these treatment modalities. The somatic considerations include including eating, swallowing and speech dysfunction,thyroid dysfunction in the irradiated neck, neurologic dysfunction related to nasopharyngeal cancer treatment and overall diminishment of functional capacity, as well as mood disorders and decreased quality of survivorship. The spectrum of late treatment effects also will demonstrate functional compromise related to xerostomia, speech alterations and residual pain. The emerging role of epidermal growth factor receptor inhibitor implementation in head and neck cancer is associated with cutaneous and ocular mucosal morbidity. Incorporation of treatment strategies which secondarily involve the need for placement of foreign bodies into the airway, gastrostomy tubes and intravenous cannulae further complicate management with potential negative impact on survival. doi:10.1016/j.oos.2009.06.030