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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

1876 - Nutritional Support Dependence after Curative Chemoradiotherapy in Head and Neck Cancer: a Supplementary Analysis of a Phase II Trial (JCOG0706S1)

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Tumour Site

Head and Neck Cancers

Presenters

Yoshinori Imamura

Citation

Annals of Oncology (2018) 29 (suppl_8): viii372-viii399. 10.1093/annonc/mdy287

Authors

Y. Imamura1, N. Kiyota2, T. Akimoto3, G. Ogawa4, J. Eba4, S. Minami5, Y. Hasegawa6, S. Iwae7, N. Monden8, K. Matsuura9, H. Fujii10, Y. Onozawa11, A. Homma12, R. Hayashi13, M. Tahara14

Author affiliations

  • 1 Medical Oncology/hematology, Kobe University Hospital, 650-0017 - Kobe/JP
  • 2 Medical Oncology/hematology, Kobe University Hospital, Kobe/JP
  • 3 Radiation oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP
  • 4 Japan Clinical Oncology Group Data Center/operations Office, National Cancer Center Hospital East, Tokyo/JP
  • 5 Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo/JP
  • 6 Head And Neck Surgery, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 7 Head And Neck Surgery, Hyogo Cancer Center, Akashi/JP
  • 8 Head And Neck Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama/JP
  • 9 Head And Neck Surgery, Miyagi Cancer Center, 981-1293 - Natori/JP
  • 10 Clinical Oncology, Jichi Medical University, Shimotsuke/JP
  • 11 Clinical Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 12 Otolaryngology-head And Neck Surgery, Hokkaido University, 060-0812 - Sapporo/JP
  • 13 Head And Neck Surgery, National Cancer Center Hospital East, Kashiwa/JP
  • 14 Head And Neck Medical Oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP
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Resources

Abstract 1876

Background

Curative chemoradiotherapy (CRT) for locally advanced head and neck cancer (LA-HNC) causes severe acute and late adverse reactions, including nutritional support dependence. The aim of this supplementary analysis of a previous single-arm phase II study of CRT with S-1 plus cisplatin for unresectable LA-HNC (JCOG0706) which demonstrated promising efficacy (Cancer Sci.2015;106:726) was to explore risk factors of laryngo-esophageal dysfunction-free survival (LEDFS) and nutritional support dependence over 12 months (NSD12M).

Methods

The study population comprised 45 patients (pts) in the JCOG0706. Risk factors of LEDFS and NSD12M were analyzed using Cox regression models and logistic regression models, respectively, with consideration to the pts’ laboratory data just before CRT. Radiation fields were reviewed to analyze the relationship between the extent of irradiated fields and functional outcomes.

Results

Proportions of alive without nutritional support at registration and 2, 6, 12, and 24 months after registration were 82.2%, 35.6%, 68.9%, 77.8%, and 64.4%. All six pts who required nutritional support at 12 months remained tube feeding-dependent thereafter. With a median follow-up period of 3.5 years of all pts, 3-year LEDFS was 48.9%. For LEDFS, the hazard ratio was 0.42 in pts with nutritional support at registration (vs. without nutritional support; 95% confidence interval [CI] 0.17-1.04). For NSD12M, odds ratio was 6.78 in pts with hemoglobin less than the median value of 13.4 g/dL (vs. higher than or equal to the median; 95% CI 1.24-36.85); and was 6.00 in pts with albumin less than the median value of 3.9 g/dL (vs. higher than or equal to the median; 95% CI 1.11-32.54). Primary sites in disease-free pts with NSD12M were the oropharynx (N = 2) or hypopharynx (N = 1), and all their pharyngeal constriction muscles were irradiated with a curative dose of 70 Gy/35 fr.

Conclusions

Functional outcomes were affected by severe dysphasia requiring nutritional support before CRT, and lower pretreatment values of hemoglobin and albumin. These risk factors should therefore be taken into consideration in planning treatment strategy for pts with LA-HNC.

Clinical trial identification

UMIN000001272.

Legal entity responsible for the study

JCOG.

Funding

National Cancer Center Research and Development Fund (23-A-16, 23-A-21, 25-B-2 and 26-A-4); Grants-in-Aid for Cancer Research (18-19, 20S-3,20S-6) from Ministry of Health, Labour and Welfare of Japan.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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