PO-106: Safety and Effectiveness of Prolonged Nasogastric Tube for Head and Neck Cancer Undergoing Radiotherapy.

4th ICHNO teatment and 5-year overall and disease specific survival in adult head and neck cancer patients. Materials and Methods: Between January 2000 and December 2008 complete data on weight change were collected in newly diagnosed head and neck cancer patients undergoing (adjuvant) radiotherapy with curative intent. Critical weight loss during radiotherapy was defined as >5% weight loss during radiotherapy or >7.5% weight loss until week 12. Differences in 5-year overall survival and disease specific survival between weight loss groups were analysed by Cox' regression with adjustments for major sociodemographic and tumor-related confounders. Results: 1364 patients were included, 70% male-30% female. Mean age was 62 years and ranged from 19-96 years. The majority of patients (48%) were stage IV, 17% stage III, 18% stage II, 16% stage I. Predominant tumor locations were pharynx (32%) and larynx (32%). Slightly more than half of the patients received a combined modality treatment. Prior to radiotherapy, 70% of patients had no weight loss, 16% had >05% weight loss, 9% had >5-10% weight loss and 5% had >10% weight loss. The 5-year overall survival for these groups were 70%, 58%, 46% and 41% respectively (p<0.001). After adjustment for socio-demographic and tumor-related confounders, >10% weight loss prior to radiotherapy remained significantly associated with a worse overall and disease specific survival (HR 1.8; 95%CI 1.2-2.7; p=0.007 and HR 2.1; 95%CI1.1-3.7; p=0.018). The 5-year overall survival and disease specific survival rates for patients with critical weight loss during radiotherapy were 62% and 82%, compared to 70% and 89% for patients without critical weight loss during radiotherapy (p=0.01; p<0.01). After adjustment, critical weight loss during radiotherapy was no longer significantly associated with overall survival. However, critical weight loss during radiotherapy remained significantly associated with a worse disease specific survival (HR 1.7; 95%CI 1.2-2.5; p=0.003). Conclusions: More than 10% weight loss prior to (adjuvant) radiotherapy is independently associated with a worse 5-year overall and disease specific survival in head and neck cancer patients. Critical weight loss during radiotherapy is independently associated with a worse 5-year disease specific survival. PO-106 SAFETY AND EFFECTIVENESS OF PROLONGED NASOGASTRIC TUBE FOR HEAD AND NECK CANCER UNDERGOING RADIOTHERAPY. V. Espeli1, S. Vergotte2, A. Clerc2, P.Y. Dietrich1, C. Pichard2 1 Geneva University Hospital, Oncology, Geneva, Switzerland 2 Geneva University Hospital, Nutrition, Geneva, Switzerland Purpose/Objective: To compare the safety and effectiveness of the prolonged (≥28 days) versus short time (<28 days) use of nasogastric tube for enteral feeding during curative radiotherapy or radiochemotherapy for head and neck cancer. Materials and Methods: Between January 2006 and September 2010, 114 patients with head and neck cancer who received enteral feeding by nasogastric tube were reviewed. Type of treatment (radiotherapy alone, chemoradiotherapy, cetuximab concurrent to radiotherapy), weight and body mass index changes and complications (gastro-esophageal reflux, pneumonia, ulcer, feeding tube blockage or ablation) were documented. Comparison were then made between prolonged (≥ 28 days, group A) and short time (< 28 days, group B) enteral feeding. Results: Ninety-two patients (81%, group A) had a nasogastric tube in place for a period ≥ 28 days and 22 (19%, group B) for < 28 days. Patients were mainly men (86 patients, 75%), with a median age < 65 years and advanced stage IV disease in most cases (87 patients, 76%) without difference in the two groups (p=0.37, 0.31 and 0.519, respectively). The most common site of tumor was the oropharynx (54 patients, 47%),

S45 followed by oral cavity (20%), hypopharynx (16%), larynx (11%), nasopharynx (5%) and unknown primary (5%). All the 114 patients were treated with curative radiotherapy, 10% alone while the other 90% received concurrent chemo- or immuno-radiotherapy. Patients treated with radiotherapy concurrent with high dose cisplatin (in comparison with low dose cisplatin, carboplatin and cetuximab) needed a significantly longer enteral feeding (29% ≥ 28 days vs. 9% < 28 days, p=0.05). Fifty-eight patients (51%) developed complications represented by feeding tube ablation (37%, 42% group A, 50% group B), feeding tube blockage (6%, 7% group A, 0% group B), pneumonia (5%, 6% group A, 5% group B), ulceration (2%, 1% group A, 5% group B) and gastroesophageal reflux (1%, 0% group A, 5% group B) without significant difference in the two groups (p=0.098). During the enteral feeding, the mean weight loss was 1.6% for the all the patients, and similar in both groups (1.8% for the group A, 0.6% for the group B; p=0.252). Conclusions: These findings suggest that prolonged nasogastric tube feeding is safe during curative radiotherapy or radiochemotherapy for head and neck cancer. PO-107 ROLE OF HONEY IN PREVENTION OF RADIATION INDUCED MUCOSITIS IN HEAD AND NECK CANCER Z. Alvi1, A. Mahmood1, S. Rasool1, U. Ali1, S. Arif1, S. Ishtiaq1, T. Maqsood1 1 Combined Military Hospital Rawalpindi, Oncology, Rawalpindi, Pakistan Purpose/Objective: To determine the efficacy of honey in preventing radiation induced mucositis (RIM) in patients with head and neck cancer. Materials and Methods: Sixty patients diagnosed with head and neck cancer requiring radiotherapy to the oropharyngeal mucosa were randomised in to two groups to receive either radiation alone or radiation and natural honey. Patients were treated using 6-MV X-ray beams from linear accelerator at a dose rate of 2 Gy per day five times a week up to a dose of 55–70 Gy. In the treatment group, patients were advised to take 20 ml of pure honey 15 minutes before, 15 minutes after and 6 hours after radiotherapy. Patients were evaluated every week for the development of RIM using the WHO oral mucositis grading system. Results: In treatment group, out of 30 patients, 4(13%) developed grade 3 RIM and none developed grade 4 RIM. In control group, out of 30 patients, 12(40%) developed grade 3 OR 4 RIM (p=0.039). 4 patients(13%) in treatment group lost more than five Kg weight during the course of radiotherapy compared to 16 patients(53%) in control group (p=0.002). Conclusions: The results of our study has shown that honey is a simple and cost effective treatment to prevent RIM. Large scale randomized trials are needed to confirm the results of our study. PO-108 ORAL MICROBIOTA ANALYSIS OF SERIAL SEQUENCING 16S RRNA IN OROPHARYNGEAL CANCER PATIENTS DURING RADIOTHERAPY Y. Choi1, J. Kim2, C. Choi3, S. An4, H. Son4, J. Chung5, H. Na5 1 Dongnam Institute of Radiological and Medical Sciences, Hematology-Oncology, Busan, Korea Republic of 2 Seoul National University Hospital, Radiation Oncology, Seoul, Korea Republic of 3 Dongnam Institute of Radiological and Medical Sciences, Radiation Oncology, Busan, Korea Republic of 4 Dongnam Institute of Radiological and Medical Sciences, Otolaryngology-Head and Neck Surgery, Busan, Korea Republic of 5 School of Dentistry Pusan National University, Oral Microbiology, Yangsan, Korea Republic of