Volume 90 � Number 1S � Supplement 2014 Poster Viewing Abstracts S511

(OS). Patient weight was determined 6 months before, at treatment start

and treatment end. Weight loss was categorized as being absent, �5%, >5-

10% or >10% and compared with patients outcome.

Results: The proportion of patients with >5% weight loss was 32% and

51% before, and during treatment, and the proportion of patients with

>10% weight loss was 12%, and 17% before and during treatment,

respectively. Weight loss before treatment was associated with age <50

years (p Z 0.006), WHO performance score above 0 (p Z 0.004) and

primary tumor site other than hypopharynx (p Z 0.04). Weight loss during

treatment was associated with radiation therapy alone (p Z 0.05). After a

median follow-up of 9.5 years (range, 0.1 e 15.4 years) weight loss before

treatment was associated with decreased TTTF, LRRFS, DMFS, cancer

specific survival and OS after multivariate analysis. However, weight loss

during treatment was not associated with survival outcomes.

Conclusions: Weight loss before and during chemoradiation was

commonly observed. Weight loss before treatment but not during treatment

was associated with decreased survival outcomes.

Author Disclosure: P. Ghadjar: None. S. Hayoz: None. F. Zimmermann:

None. S. Bodis: None. D. Kaul: None. J. Bernier: None. G. Studer:

None. L. Plasswilm: None. V. Budach: None. D.M. Aebersold: None.

2759Clinical Factors With Respect to Cervical Body Volume ReductionDuring Definitive External Beam Radiation Therapy forOropharyngeal Squamous Cell CarcinomaK. Takeda,1 S. Dobashi,1 S. Komori,1 K. Chida,1 N. Kadoya,2 K. Itoh,2

T. Sugawara,2 M. Kubozono,2 R. Umezawa,2 Y. Ishikawa,2 T. Yamamoto,2

T. Fujimoto,2 M. Kozumi,2 Y. Onozato,2 T. Suzuki,3 H. Matsushita,2

and K. Jingu2; 1Course of Radiological Technology, Health Sciences,

Graduate School of Medicine, Tohoku University, Sendai, Japan,2Department of Radiation Oncology, Tohoku University Hospital, Sendai,

Japan, 3Department of Head and Neck Surgery, Tohoku University

Hospital, Sendai, Japan

Purpose/Objective(s): Substantial cervical body volume reduction

(CBVR) occurs during fractionated external beam radiation therapy

(EBRT) for head and neck cancer and could have dosimetric effects.

Adaptive radiation therapy (ART) can address this issue, if necessary.

However, it remains unclear whether all patients derive a significant benefit

from routine ART. Our aim was to evaluate clinical factors affecting

CBVR rates (CBVRR) during definitive conventional EBRT for oropha-

ryngeal squamous cell carcinoma (OSCC).

Materials/Methods: We retrospectively studied 52 OSCC patients treated

with definitive conventional EBRT to the primary tumor and metastatic

lymph nodes (LN) between November 2006 and January 2013. This study

included 45 men (87%) and 7 women (13%) with a median age of 65 years

(range, 38-82 years). No patients received prior surgery for OSCC. The

daily dose was 2 Gy, five times weekly in all patients. For EBRT planning,

computed tomography (CT) images were acquired before EBRT initiation

and 3 to 5 weeks after the start of EBRT for re-planning in each patient.

We evaluated CBVRR between the initial and re-planning CT images

using a MATLAB program. Forty-four patients (85%) received concurrent

chemotherapy (CC) using the following regimens: TPF [docetaxel (DOC),

cisplatin (CDDP) and 5-fluorouracil (5-FU)] in 28 (54%); another CDDP-

based regimen in 13 (25%); and DOC in 3 (6%). The remaining 8 patients

(15%) did not receive CC. Six patients were staged as T1 tumors (12%), 17

as T2 (32%), 15 as T3 (29%) and 14 as T4 (27%). Nine patients were

staged as N0 (17%), 3 as N1 (6%), 3 as N2a (6%), 17 as N2b (33%), 16 as

N2c (31%) and 4 as N3 (7%). Multiple linear regression was performed to

explore clinical factors affecting CBVRR. The following clinical variables

were assessed: age, gender, T stage, N stage, use of CC and the regimen.

Backward stepwise regression was performed, and a P value greater than

0.20 was used for variable removal. P < 0.05 was defined as statistically

significant. The institutional ethical review board approved this study.

Results: The median CBVRR was 6.7% (range, 1.8-17.1%). The final

linear regression model identified N3 stage (95% confidence interval [CI]

0.328-7.536, P Z 0.033) and T4 stage (95% CI 0.222-4.553, P Z 0.031)

as significant variables influencing CBVRR. Thus, regional metastatic LN

> 6 cm in greatest dimension and T4 stage were associated with sub-

stantial CBVRR.

Conclusions: CBVRR appears to be associated with bulky regional LN

metastasis and T4 stage in OSCC. OSCC patients with these factors may

benefit from ART.

Author Disclosure: K. Takeda: None. S. Dobashi: None. S. Komori:

None. K. Chida: None. N. Kadoya: None. K. Itoh: None. T. Sugawara:

None. M. Kubozono: None. R. Umezawa: None. Y. Ishikawa: None. T.

Yamamoto: None. T. Fujimoto: None. M. Kozumi: None. Y. Onozato:

None. T. Suzuki: None. H. Matsushita: None. K. Jingu: None.

2760Compliance With Quality Assurance Measures for ImprovingOropharyngeal Cancer Patient CareO.H. Gayar, Y. Yu, S. Chang, T. Ghanem, F. Hall, and F. Siddiqui; Henry

Ford Health System, Detroit, MI

Purpose/Objective(s): Head and neck cancer therapy practices vary

widely between institutions. There are currently no well accepted methods

to evaluate the quality of care provided. We evaluated the quality of care

provided to patients with oropharyngeal squamous cell cancers (OPSCC)

at our institution based on compliance with American Head and Neck

Society and National Comprehensive Cancer Network (NCCN) guidelines.

Materials/Methods: An IRB approved retrospective chart review of 84

patients treated for T1-4bN0-3 OPSCC from 2010-2013 was performed.

Quality measures included smoking and alcohol history, fiberoptic/mirror

and physical exams, radiographic work up, proper staging, multidisci-

plinary tumor board (MTB) discussion, speech-swallow evaluation (SLP),

and HPV testing. For surgical patients, tumor size, grade, margin status,

lymphovascular invasion (LVI), perineural invasion (PNI), neck dissection,

extracapsular extension (ECE), appropriate referral for adjuvant therapy,

appropriate adjuvant treatment, and adjuvant therapy within 11 weeks were

checked. For those receiving radiation (RT), appropriate dose was defined

as 70 Gy equivalent definitively or 60-66 Gy adjuvantly. Appropriate

chemotherapy (Ch) was checked for those who received it. Surveillance

imaging as a PET or CT neck within 12 weeks of treatment completion and

clinical follow up were also reviewed.

Results: Of 84 patients, 66 completed treatment at our institution and were

deemed eligible for review. 48 (74%) patients had SLP evaluation. 43

(65%) were tested for HPV. All patients were presented at a MTB. 31

(47%) had surgery: of which 29, 31, and 30 patients had tumor size,

margin status, and grade documented. LVI and PNI were documented for

29 patients each. Neck dissection was done and documented in 30 (97%)

patients. Of 24 pathologically node positive patients, all were checked for

ECE. 21 of the 31 surgical patients needed adjuvant therapy of which,

appropriate referral was made in 20 (95%). The time between surgery and

adjuvant RT was kept under 11 weeks in 11 (55%) patients. Of all 66

patients, 55 (83%) received RT, and appropriate RT dose was given in 54

(98%) of them. 49 patients received Ch and appropriate Ch was given in 48

(98%) of them. Appropriate total treatment for all 66 patients was given in

64 (97%) with appropriate clinical follow up at our institution in 65 (99%)

patients. 36 (55%) patients had surveillance imaging within 12 weeks of

treatment completion.

Conclusions: Compliance with delivery and documentation of certain

quality of care measures for OPSCC appear to be acceptable. Through this

analysis we have identified areas for improvement. To our knowledge, this

is the first attempt to establish quality guidelines for OPSCC treatment.

Standardization of quality metrics and adherence to them is imperative to

allow for meaningful cross-institutional comparison of local control and

survival data.

Author Disclosure: O.H. Gayar: A. Employee; Henry Ford Health Sys-

tem. Y. Yu: A. Employee; Henry Ford Health System. S. Chang: A.

Employee; Henry Ford Health System. T. Ghanem: A. Employee; Henry

Ford Health System. F. Hall: A. Employee; Henry Ford Health System. F.

Siddiqui: A. Employee; Henry Ford Health System. S. Leadership; Vice-

Chair of Clinical Operations.