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morbidities that radiation would leave behind. Microbial analysis of saliva samples
was done from healthy volunteers (n = 35), tobacco chewers (n = 37) (Age & Sex
matched), OSCC (n = 32) and during radiotherapy (n = 31) of these patients (∼ 50%
study samples form a series). Frequency of isolation and mean colony forming units
obtained were subjected to Kruscal - Wallis, Mann - Whitney (unpaired values) and
Wilcoxson - signed rank test (paired values) for comparison.
Results: No isolation of Citrobacter, Enterobacter, Proteus in normal samples and
Corynebacteria, Staphylococcus epidermidis in study samples. Tobacco – induced
change: Among aerobes, E. coli, Citrobacter, Proteus, Klebsiella pneumonia and
Enterobacter increased (p < 0.05), whereas, Streptococcus pneumoniae,
Corynebacteria, Staphylococcus epidermidis, aerobic Streptococci decrease (p < 0.05)
significantly. Amongst the anaerobes, anaerobic Streptococci, Prevotella decreased
while Fusobacteria, P. gingivalis increased, but, all non - significantly (p > 0.05).
Tumor - induced change: E. coli, Enterobacter and anaerobic Streptococci,
Fusobacteria, Prevotella (anaerobes & GNAB) significantly increased (p < 0.05).
Radiation – induced change: Among aerobes, Streptococcus pneumoniae,
Staphylococcus epidermidis decreased. Proteus, Klebsiella pneumoniae, Enterobacter,
and amongst anaerobes, Streptococci increased (p < 0.05) significantly. A
non-significant increase was noted in Fusobacteria and P. gingivalis.
Conclusions: The study impresses on the rapidly modifying nature of OMF that
accommodates non – residents and increasing proportions of more pathogenic
microorganisms that may contribute to the enhanced morbidity.
Disclosure: All authors have declared no conflicts of interest.
1050P WHOLE-BODY DIFFUSION MRI AND SKELETAL LESIONS IN
THYROID CANCER: DIAGNOSTIC AND THERAPEUTIC
IMPLICATIONS
L. Locati 1 , R. Granata 1 , P. Potepan 2 , G. Aliberti 3 , E. Civelli 4 , P. Bossi 1 ,
E. Montin 2 , L. Licitra 1
1 Head & Neck Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan,
ITALY, 2 Department of Radiodiagnostic, Fondazione IRCCS - Istituto Nazionale
dei Tumori, Milan, ITALY, 3 Department of Nuclear Medicine, Fondazione IRCCS -
Istituto Nazionale dei Tumori, Milan, ITALY, 4 Department of Diagnostic Imaging
and Radiotherapy, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan,
ITALY
Background: Forty-fifty percent of the patients with metastatic TC suffer from bone
metastases. 99m Tc scintigraphy is employed to assess bone lesions although it lacks of
accuracy, mostly in lytic lesions of differentiated thyroid cancer (DTC). CT scan has
a sensitivity of 71-100% while data on the accuracy of 18 F-FDG-PET/CT are scanty.
MRI captures both bone and bone marrow involvement, more common in medullary
thyroid cancer (MTC). Whole body MRI (WB) and whole-body diffusion
(WB-DWI) are emerging as accurate tools for detection and therapy monitoring of
bone metastases. We investigated the role of WB and WB-DWI in bone lesions from
TC i) sensitivity and specificity; ii) evaluation of response during TKIs.
Material and methods: Radiological records of patients with metastatic TC
submitted to WB-DWI at the baseline staging were reviewed. For our first purpose,
patients with at least one another bone imaging were included. A false-positive was a
positive bone imaging not confirmed by histopathology or/and another imaging
technique or by two imaging exams. A false-negative was a negative finding on bone
imaging and a positive one on another imaging method plus histopathology or by
two imaging methods. For each imaging modality, sensitivity, specificity and accuracy
were calculated. For the secondary aim were considered only patients scanned by
WB-DWI at baseline and during TKIs treatment.
Results: Since 2010, nine MTC (5M/4F) and five DTC (3M/2F) patients were
selected. Results of the first aim are listed in the table.
WB-DWI Bone scan Bone CT
Number of
exams
14 12 12
True-positive 10 8 8
True-negative 4 4 4
False-positive 0 1 (MTC) 0
False-negative 0 1 (DTC) 1 (MTC)
Sensitivity % 100 88 88
Specificity % 100 80 100
Accuracy % 100 86 92
In five (4 MTC/1 DTC) out eight (62%) true-positive bone scan, WB-DWI
demonstrated a higher number of bone lesions. In three patients (2 MTC/1 DTC),
WB-DWI showed a cystic evolution in the responding lesions during TKI (apart
from the histotype).
Conclusions: In our hands WB-DWI is the best imaging method to identify bone
lesions from TC. It could potentially address unmet clinical and therapeutic needs
for a reliable measure of bone lesion response in this rare tumors.
Disclosure: All authors have declared no conflicts of interest.
1706P ANTI-ANDROGEN THERAPY FOR THE PATIENTS WITH
RECURRENT AND/OR METASTATIC SALIVARY DUCT
CARCINOMA EXPRESSING ANDROGEN RECEPTORS: A
RETROSPECTIVE STUDY
Y. Yajima 1 , S. Fujii 2 , T. Kobayashi 1 , H. Ishiki 1 , R. Hayashi 3 , M. Tahara 4
1 Head And Neck Medical Oncology, National Cancer Center Hospital East,
Kashiwa, Chiba, JAPAN, 2 Pathology, National Cancer Center Hospital East,
Kashiwa, Chiba, JAPAN, 3 Head And Neck Surgery, National Cancer Center
Hospital East, Kashiwa, Chiba, JAPAN, 4 Endoscopy & Gi Oncology, National
Cancer Center Hospital East, Kashiwa, Chiba, JAPAN
Background: Salivary duct carcinoma (SDC) is one of the WHO classified
histological types of salivary gland tumors (SGT) and consists of less than 10%
among all the SGT. SDC is known as highly malignant with its aggressive clinical
course, high rate of recurrence and metastasis and 2-3 years of median survival time.
Up-front therapy is surgery, but treatment option is quite limited when it recurs and/
or metastasis not being suitable for surgical resection. Androgen receptor (AR) is
expressed in about 90% of SDC. Several reports suggest that AR would be a good
candidate for treatment target for this entity.
Patients and methods: We conducted a retrospective analysis in patients with AR
positive, recurrent and/or metastatic SDC treated anti-androgen therapy in our
institution from January 1997 and April 2012. AR positivity was defined by
immunohistochemistry (AR441, DAKO). Anti-androgen therapy was given as a
single agent LH-RH analogue every four weeks until disease progression or
intolerable adverse events. Responses to anti-androgen therapy were assessed
according to RECIST.
Results: Eight patients were included. All were male. Median age was 57 years (range
40-76). Primary site was parotid gland in 7 and submandibular gland in 1. Initial
clinical stage was II in 2, IVA in 5 and IVC in 1. All patients had received surgery for
SDC prior to anti-androgen therapy. The patterns of relapse were locoregional
recurrence in 4 and distant metastasis in all. Median number of cycles of
anti-androgen therapy was 4 (range 2-10). No serious adverse event was seen. The
best responses were PR in 2 and SD in 3, and median time of response duration was
4.6 months. After progression of anti-androgen therapy, all but one received
chemotherapy included platinum compounds, taxanes and fluorouracil. Median
overall survival time from receiving anti-androgen therapy was 22 months.
Discussion and conclusion: Anti-androgen therapy was well tolerated and
demonstrated promising clinical activity for patients with recurrent and/or metastatic
SDC. This might delay the start of chemotherapy and provide survival benefits, and
this approach warrants further investigation.
Disclosure: All authors have declared no conflicts of interest.
1051 INDUCTION CHEMOTHERAPY (CT) WITH DOCETAXEL,
CISPLATIN, AND FLUOROURACIL (TPF) FOLLOWED BY
CONCOMITANT CISPLATIN PLUS RADIOTHERAPY IN
LOCALLY ADVANCED NASOPHARYNGEAL CANCER (NPC)
RESULTS AFTER 03 YEARS
E. Kerboua, N. Lagha, A. Arab, S. Chami, F. Mekki, K. Bouzid
Medical Oncology, Centre Pierre et Marie Curie, Algiers, ALGERIA
Annals of Oncology
Backround: in squamous cell carcinoma of head and neck cancer,TPF induction CT
improved survival over cisplatin and fluorouracil (MR POSNER NEJM, vol 357 oct
2007 ). The main objectif of this study is to evaluate the activity and safety of TPF in
patients (pts) with locally advanced NPC followed by concomitant cisplatin plus
radiotherapy (cCTRT).
Methods: pts with undifferenciated NPC were enrolled from December 2006 to
December 2010, and received 3 cycles of TPF (docetaxel 75mg/m2 day, and cisplatin
75mg/m2 day 1, plus fluorouracil 750 mg/M2 days 1-5, every 4 wks) with G-CSF days
1-5 post CT. Induction CT was follwed by cCTRT with cisplatin 40 mg/m2/wk and
radiotherapy (65-70 gy) starting 4-6 wks after the third cycle of induction CT. The
primary endpoint was overall response rate (ORR) after induction CT and after cCTRT.
Secondary end points were toxicity, disease free survival (DFS), and overall survival (OS).
Results: Fourty-two (42) pts with locally advanced NPC have been enrolled (26M/16F).
UICC 1997 classification: n = 9 stage II, n = 10 stage III, n= 23 stage IV (n = 10 IVA; n =
11 IVB). Median age is 37 yrs (range 18-64). Evocative clinical signs are cervical nodes n
= 20, rhinologic n = 13, otologic n = 5, and neurologic n = 4. All pts were evaluated for
safety and 38 for response. TPF was well tolerated with main toxicities grade 3-4 (WHO)
consisting of neutropenia 36%, thrombocytopenia 23%, anemia 18%, diarrhea 6%,and
mucositis 18%. Four pts died from sepsis that was probably treatment-related. ORR was
90% with 71,4% (n = 27) complete response (CR) rate, 23,6% (n = 9) partial response
(PR), and 5,2% (n = 2) stable disease. No pts progressed after induction CT. Main toxicity
during cCTRT was neutropenia grade 3-4 in 9%, mucositis grade 3 in 45% and grade 4
in 4%. Late toxicities were xerostomia grade 3 in 50%. At treatment completion, CR and
PR rates were 79% and 20%; 2 pts had stable disease. At a median follow up of 36
months (7-48), 5% of pts have shown recurrence or progressive disease. DFS and OS
rates at 36 months were 70% and 75%, respectively.
ix344 | Abstracts Volume 23 | Supplement 9 | September 2012