No abstract

e18059 Background: We investigated the efficacy and safety of docetaxel + cisplatin (DC) induction chemotherapy vs TPF in patients with locally advanced HNSCC. Methods: Under our observation there were 22 patients in HNSCC (63,6% men and 36,4% women, aged 43 to 74 years (58.7±9.4 (95% CI 55.0-62.4)). The control group consisted of 18 patients (72,2% men and 27,8% women, aged 43 to 73 years (53.9±8.8 (95% CI 49.6-58.3). Both groups were comparable in terms of location, stage (III-IVA) and tumor differentiation. The patients of group 1 received DC (docetaxel 75 mg/m2 + cisplatin 75 mg/m2; q3w) as induction chemotherapy (ICT), while patients in the control group received TPF. Results: The planned number of ICT cycles (No. 3) in group 1 was received by 100% pts. and in the control group - 77.78% pts. (p = 0.02). At the control assessment according to RECIST 1.1, PR was registered in 77.3% pts. of group 1 vs 55.5% pts. in control group (p = 0.14), SD - in 22.7% vs 33.3: (p = 0.45), PD was registered only in patients of the control group - in 11.2% (p = 0.11). The frequency of registration of AEs: diarrhea gr.1-3 - 9.1% pts. group 1 vs 33.3% of pts. the control group (p = 0.06), nausea gr.1 -2 - 9.1% vs 22.2% (p= 0.25), asthenia gr. 1-2 - 4.5% versus 16.7% (p = 0.20), anemia gr. 1-2 - 9.1% vs. 16.7% (p = 0.47), neutropenia gr. 3-4– 4.5% versus 16.7% (p = 0.20). Reduction of doses of cytostatic up to 50% was performed in 4.5% pts. in group 1 and 16.7% pts. in the control group (p = 0.20). Conclusions: Induction chemotherapy in DC mode may be an effective and safe regimen in certain groups of patients with HNCH (for example, in patients with contraindications to 5-FU infusions, as well as in patients with high-risk HHNH for alternative surgical treatment or concurrent CRT as initial treatment of localized and locally advanced HNSCC.

No abstract

e17519 Background: The purpose of our study was to investigate prognostic role of neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio in PFS and OS, and immunological tumor’s microenvironment in patient with HNSCC. Methods: We analysed medical records an tumor samples of 60 patients with HNSCC with stage I - IVB (37 men, 23 women; median age 59). All patients were under standard clinical complex protocol. All patients were under our supervision from 2010 to 2015. We examined demographic data, clinical stage, tumor morphological characteristics and specific level of expression of CD8(+) T-cells, in the tumor and microenvironment, and baseline level of WBC, neutrophil, lymphocyte, monocyte and PLT . Also we analysed calculated value of NLR, dNLR, PLR, and LMR. Results: The median value of NLR was 2.03 (95% CI: 1.66-2.59), dNLR - 1.44 (95% CI: 1.23-1.70), PLR - 144.58 (95% CI: 107.59-179.32) and LMR - 6.79 (95% CI: 5.34-8.17). Median of 1-year OS and PFS was non significantly lower in pts with NLR < 2.03 (16.0 vs 18.0 month, p = 0.6020 and 5.00 vs 7.00 month, p = 0.5383). But NLR correlate with expression of CD8(+) T-cell in tumor (p = 0.05). Median of 1-year OS was the same in both group (16.0 vs 17.0 month, p = 0.5453), PFS was non significantly lower in pts with dNLR < 1.44 (16.0 vs 18.0 month, p = 0.6020 and (5.00 vs 7.00 month, p = 0.7435). NLR correlate with expression of CD8(+) T-cell in tumor (p = 0.0337). Analyse of LMR showed trend of best 1-year OS in pts with LMR < 6.79 (18.0 vs 15.0 month, p = 0.4674) and equal PFS (6.00 vs 7.00 month, p = 0.4914). PFS and 1-year OS were better (nonsignificant) in pts with PLT > 144.58 (9.0 vs 5.0 month, p = 0.5854) and (18.0 vs 16.0 month, p = 0.5836). Conclusions: Important role of indicators of systemic inflammation is obvious for patient with HNSCC, but our study showed that only baseline characteristics couldn’t be strong prognostic factors by different degree of intratumor inflammation.

e18539 Background: The objective of our study was to evaluate the prevalence of DNA of HSV I, II, CMV, EBV, HPV6.11, HPV16, HPV18 in normal oral mucosa and oral squamous cell carcinoma (OSCC), and determine this association with long-term treatment outcomes and patient survival. Methods: The study included 116 patients with OSCC (stage I-IVB who received standard treatment) and 50 healthy volunteers, median age 60.0 yrs (95% CI 58.0-64.0). Using real-time PCR (polymerase chain reaction), freshlyfrozen samples of the tumor and normal mucous membranes of the cavity were analyzed. mouths, which, after collection, were placed in an EDTA solution and frozen at 20°C. Results: In 54 (46.55%) OSCC and 17 (34.00%) normal mucous viral DNA was not found (p = 0.13). The occurrence of DNA (OSCC vs. normal) of the following viruses was the same in both OSCC and normal mucosa: HSV I, II: 2 (1.72%) vs. 2 (4.00%) (p = 0.38); EBV: 40 (34.48%) vs. 15 (30.00%) (p = 0.57); CMV: 5 (4.31%) vs. 2 (4.00%) (p = 0.93); HPV6.11: 16 (13.79%) vs. 6 (15.00%) (p = 0.84); HPV16: 12 (10.34%) vs. 2 (4.00%) (p = 0.18). HPV18 DNA: 20 (17.24%) vs. 24 (48.0%) (p <0.0001) was found significantly less frequently in the OSCC group. In addition, EBV + HPV18: 7 (14.00%) vs. 5 (4.31%) (p = 0.0270) was more common vs. OSCC in the group of healthy volunteers; CMV + HPV18: 2 (4.00%) vs. 0 (p = 0.0302). In the OSCC group, patients with stage III disease were more often virus-positive (p = 0.0137); the pterygo-maxillary fold region (p = 0.0438); with partial keratinization of cells (p = 0.05). PFS in the HPV18 (+) OSCC group was 38.5 months (95% CI 11.00-66.0) and 23.5 m higher than the group of HPV18 (-) patients (HR = 0.63; 95% CI 0.39-1.03; p = 0.0399). In virus-negative patients, PD was more often recorded: 12 (24.00%) vs. 2 (3.03%) (p = 0.0006). In the group of virus-positive patients, OS and PFS, even with non-radical treatment, were significantly higher than virus-negative patients with radical treatment. OS: vir (+)/non-radical = 69.0 mo vs. vir (-)/radical = 15.0 mo (HR = 0.22; 95% CI 0.11-0.47; p <0.0001). PFS: vir (+)/non-radical = 56.0 mo vs. vir (-)/radical = 11.0 mo (HR = 0.20; 95% CI 0.09-0.45; p <0.0001). Conclusions: The association of OSCC with viral DNA, especially HPV18, is a favorable prognosis of the disease and a longer OS and PFS, even when radical treatment is not possible.