McGee, L.A.

513 Background: The PCG registry is a multicenter registry for patients receiving proton therapy for various malignancies. The current abstract reviews the outcomes for patients receiving postoperative proton therapy for resected pancreatic cancer. Methods: From March, 2013 to August,2016 18 patients with resected pancreatic adenocarcinoma received postoperative proton therapy. The current study reviews the pretreatment characteristics and outcomes of these patients. Results: Median age -70 years (range 52 to 79); Males 12, Females 6; pT Stage -T2–4, T3–13, T4–1; N Stage -N1–12, N0–6; Margin Status -Close-8, Positive-4, Negative-6; Surgical approach -open-16, laparoscopic 2; Operations performed: standard pancreaticoduodenectomy-11, pylorus sparing pancreaticoduodenectomy-4, total pancreatectomy-1; Pancreaticoduodenectomy with portal vein reconstruction –1; Pancreaticoduodenectomy with irreversible electroporation. Median lymph nodes taken-16.50 (range 3 to 72); Median lymph nodes positive-1.5 (range 0 to 7); PNI positive-9, PNI negative-2, PNI unknown-4; LVI positive-7, LVI negative-6, LVI unknown-5; Median tumor size –3.1cm (range 2.2 to 6.2); Median dose delivered –50.51Gy(RBE) (range 27.88 to 54.00); Median treatment duration –38 calendar days (range 25 to 48); One patient died during treatment. One additional patient demonstrated grade 3 toxicity (anorexia, nausea, diarrhea). Only one patient’s treatment was protracted by more than 5 days. Median available follow up is 1.1 years (range 0.07 to 3.4 years); 2 year survival 37%. Conclusions: Postoperative proton therapy after pancreatectomy was well tolerated without treatment interruption or severe toxicity.

Objectives/HypothesisSarcomatoid carcinoma is a rare variant of squamous cell carcinoma of the head and neck. No consensus exists on its management. Our aim was to present our outcomes.Study DesignRetrospective study. Median follow‐up 45 months.MethodsThere were 38 patients with pathologically confirmed sarcomatoid carcinoma of the larynx treated at the Mayo Clinic from 1990 to 2014. Statistical analysis of overall survival (OS), progression‐free survival (PFS), and local control (LC) were conducted using the Kaplan‐Meier method.ResultsThe majority of patients were elderly males (92%) with a smoking history (74%) presenting with early‐stage disease (71%). Surgery alone was the primary treatment in 27 patients (71%). Nine patients (25%) were treated with adjuvant radiation due to initial stage or high‐risk pathologic features. Median radiation dose to the primary/surgical bed was 65 Gy (range, 60.3–75.0 Gy). A total of 15 patients (39%) had tumor recurrence, majority being local (n = 12). Sixty percent (n = 9) had multiple local recurrences. Five‐year OS, PFS, and LC were 63%, 46%, and 72%, respectively. Subgroup analysis by stage I versus higher stages (II–IV) showed an OS of 80% versus 43% (P = .030), PFS of 65% versus 18% (P = .003), and LC of 84% versus 57% (P = .039).ConclusionsSarcomatoid carcinoma of the larynx is rare, and frequently presents at an early stage in older men with history of smoking. Based on our outcomes and patterns of failure, it appears early‐stage tumors are treated appropriately with single‐modality therapy, whereas more advanced tumors require multimodality therapy. Validation in a larger cohort is warranted.Level of Evidence4. Laryngoscope, 128:373–377, 2018