S539
Clinical – Head & neck
ESTRO 2026
estimate the absolut benefit of PORT in a patient with resected major salivary gland carcinoma (SGC). Material/Methods: Major SGC patients treated with curative-intent surgery between 2000 and 2021 at five tertiary cancer centers were identified. Prognostic factors (p<0.05) identified on multivariable analysis and clinicopathologically relevant characteristics were utilized to construct a nomogram to estimate the five- year LRF risk. Subsequently, we estimated the benefit of PORT on the five-year LRF and OS for each nomogram point-value. Results: A total of 1175 patients were included in the analysis (Canada, Brazil, USA). The median follow-up was 5.3 years (IQR, 3.1-8.6 years). The nomogram for prediction of five-year LRF risk comprised six statistically significant factors (lymphovascular invasion [100 points], WHO high-risk histology [84 points], involved resection margins [61 points], parotid primary tumor [69 points], pathologic T3-4 category [44 points], and the non-utilization of PORT [57 points]), and two relevant factors (pathologic nodal involvement [34 points] and perineural invasion [7 points]). The corrected C-index was 0.77. We estimated the values of five-year LRF and OS depending on the PORT (see Figure 1A and 1B). For example, consider a patient who underwent curative-intent surgery for a SGC of the parotid (69 points). Pathological examination showed a low-grade mucoepidermoid carcinoma (WHO low-risk, 0), staged pathologic T3 (44 points) N1 (34 points), with involved resection margins (61 points) and evidence of lymphovascular invasion (100 points), but no perineural invasion (0 points). The cumulative score on the nomogram is 308, corresponding to an estimated five-year LRF rate of 27% without PORT vs 16% with PORT, and a five-year OS of 55% without PORT vs 71% with PORT. Therefore, the estimated benefit of PORT for this patient is an 11% reduction in five-year LRF.
factors for laryngeal squamous cell carcinoma: a single-center retrospective study. Front Oncol 2021;11:606010Song Z, Chen Z, Sun X, et al. Competing risk models versus traditional Cox models for prognostic factors’ prediction and care recommendation in patients with advanced laryngeal squamous carcinoma: a population-based study. Eur Arch Otorhinolaryngol 2023;280:3745–56.Kitani Y, Kubota A, Furukawa M, et al. Prognostic factors for local control in patients receiving radiation therapy for early glottic cancer: anterior commissure involvement and effect of chemoradiotherapy. Eur Arch Otorhinolaryngol 2016;273:1011–7. Keywords: Locally advanced larynx cancer, curative CRT Digital Poster Highlight 411 Refining adjuvant radiation therapy decision in major salivary gland carcinoma using individualized nomogram-based prediction Max Gau 1 , Jie Sue 2 , Shao Hui Huang 1 , Fatimah A. Alfaraj 3 , Osama Souied 4 , Michelle L. Mierzwa 5 , Gustavo N. Marta 6 , Luiz P. Kowalski 7 , Fabio Y. Moraes 8 , Wei Xu 2 , Andrew Bayley 1 , Ezra Hahn 1 , John J. kim 1 , Andrew McPartlin 1 , Brian O’Sullivan 1 , Andrew Hope 1 , C. Jillian Tsai 1 , Nauman Malik 1 , John Waldron 1 , Scott V. Bratman 1 , Hamna Javed 9 , John R. De Almeida 10 , Christopher M.K.L. Yao 10 , Ali Hosni 1 1 Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada. 2 Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada. 3 Department of Radiation Oncology, BC Cancer Centre for the North, Prince George, Canada. 4 Department of Medical Oncology, Allan Blair Cancer Centre, Regina, Canada. 5 Department of Radiation Oncology, University of Michigan Health, Ann Arbor, USA. 6 Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil. 7 Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, Sao Paulo, Brazil. 8 Department of Oncology, Kingston General Hospital, Kingston, Canada. 9 Department of Family Medicine, University of British Columbia, Vancouver, Canada. 10 Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Canada Purpose/Objective: The benefit of post-operative radiotherapy (PORT) in major salivary gland carcinoma (SGC) remains uncertain due to heterogeneous histology and multiple interrelated risk factors, making individualized treatment decisions challenging. This study aimed to develop and validate a nomogram to estimate the risk of locoregional failure (LRF) and
Conclusion: This nomogram provides a robust estimate of LRF in patients with resected major SGC. It may serve as a clinically useful tool to support individualized treatment decision-making in the adjuvant setting by estimating the added benefit of PORT in reducing LRF, and its translation in OS. Keywords: Salivary gland cancer, post operative radiotherapy
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