S667
Clinical – Head & neck
ESTRO 2026
(p=0.039), DFS (p=0.038), and DMFS (p=0.028). Acute toxicities were more frequent with CRT (81.9% vs. 62.5%, p=0.009), whereas late toxicities did not differ significantly between the two groups (29.4% vs. 23.2%, p=0.408).
Digital Poster 4826 Redefining the role of concurrent
chemoradiotherapy in the adjuvant treatment of laryngeal cancer: a propensity score–matched analysis Ecem Yigit 1 , Ozlem Ozkaya Akagunduz 2 , Tugce Bozkurt Vardar 2 , Mervenur Bay 1 , Mustafa Cengiz 1 , Gokhan Ozyigit 1 , Ibrahim Gullu 3 , Sercan Aksoy 3 , Oguz Kuscu 4 , Gozde Yazici 1 1 Department of Radiation Oncology, Hacettepe University, Ankara, Turkey. 2 Department of Radiation Oncology, Ege University, Izmir, Turkey. 3 Department of Medical Oncology, Hacettepe University, Ankara, Turkey. 4 Department of Otorhinolaryngology, Hacettepe University, Ankara, Turkey Purpose/Objective: To compare survival outcomes and identify prognostic factors in patients with laryngeal cancer who underwent surgery followed by adjuvant radiotherapy (RT) or chemoradiotherapy (CRT). Material/Methods: A total of 278 patients with laryngeal cancer treated between 2008 and 2022 were retrospectively evaluated. A propensity score–matched (PSM) analysis was performed to minimize treatment-selection bias. PSM was conducted at a 1:1 ratio based on age, Eastern Cooperative Oncology Group (ECOG) performance status, T and N classification, tumor size, lymphovascular space invasion (LVSI), perineural invasion (PNI), surgical margin (SM) status, and extranodal extension (ENE). Survival outcomes were estimated using the Kaplan–Meier method and compared with the log-rank test. Multivariable Cox regression was used to identify independent prognostic factors. Results: After PSM, 144 patients (72 per group) were included in the matched cohort. Before matching, patients in the CRT group were younger, had better ECOG performance status, and showed a higher prevalence of nodal disease and ENE. Following matching, the two groups were well balanced across all covariates. With a median follow-up of 70 months (range, 3–185 months), the 5-year overall survival (OS), disease-free survival (DFS), distant metastasis–free survival (DMFS), and locoregional recurrence–free survival (LRRFS) rates in the PSM cohort were 65.2%, 62.7%, 62.7%, and 65.0%, respectively. On multivariable analysis, younger age (<62 years), absence of PNI, and adjuvant treatment with CRT were independently associated with improved OS, DFS, DMFS, and LRRFS, whereas ENE predicted worse DFS, DMFS, and LRRFS. In the subgroup analysis excluding patients with high-risk features (ENE+ and/or SM+), CRT remained an independent favorable prognostic factor for OS
Conclusion: In the adjuvant treatment of laryngeal cancer, concurrent CRT emerged as an independent positive prognostic factor across all survival endpoints. These findings support the notion that the benefit of CRT may extend beyond traditionally defined high-risk groups, highlighting its potential relevance in broader postoperative settings. Prospective studies are required to validate these observations and refine clinical decision-making for concurrent CRT. Keywords: postoperative radiotherapy, survival outcomes
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