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spine, respectively. The reasons for tx were pain (73%), pain and neurological deficit (ND) (13%), asymptomatic (10%), and ND only (3%). Actuarial median time to pain relief was 1.8 mo. Actuarial median overall survival, time to radiographic failure, and time to pain failure were 13.6 mo, 26.5 mo, and 56.6 mo, respectively. Univariate analysis showed that higher consult KPS (OR Z 1.03, p Z 0.03), female gender (ORZ 1.80, p Z 0.02), higher prescription dose (OR Z 1.30, p Z 0.007), and tumor location of C/T vs lumb (OR Z 1.81, p Z 0.04) but not C/T vs scr (ORZ 2.16, p Z 0.16) nor lumb vs scr (OR Z 1.19, p Z 0.76) were predictors for development of PFL. On multivariate analysis, higher consult KPS (OR Z 1.03, p Z 0.04), female gender (OR Z 1.92, p Z 0.01), higher prescription dose (OR Z 1.28, p Z 0.02), and tumor location of C/T vs lumb (ORZ 1.81, pZ 0.04) but not C/T vs scr (ORZ 2.08, pZ 0.19) or lumb vs scr (OR Z 1.15, p Z 0.82) remained predictors. Besides prescription dose, no other dosimetric factors predicted PFL. Conclusions: PFL is an infrequent complication of sSBRT. Predictors include higher consult KPS, female gender, higher prescription dose, and C/T tumor location. Dose to the spinal cord was not a predictor of PFL. Since a minority (15%) of tx resulted in PFL, we do not routinely utilize prophylactic steroid treatment; however, prophylactic steroids maybe considered in female pts with C/T metastases. Author Disclosure: D.L. Jung: None. E.H. Balagamwala: None. L. Angelov: None. J.H. Suh: None. C.A. Reddy: None. T. Djemil: None. A. Magnelli: None. S. Soeder: None. S.T. Chao: None.

Materials/Methods: After obtaining IRB approval, we identified 96 patients who had undergone total laryngectomy for SCC of the larynx between 2003 and 2010 and who had preoperative CT scans at Emory. GTV, as defined by preoperative diagnostic CT scan, was contoured and measured using Eclipse Treatment Planning software (Varian, Palo Alto, CA). Pathologic information on arytenoid, cricoid, and hyoid destruction and TC penetration was obtained from the pathology reports. The association between GTV and extralaryngeal spread was evaluated.

Results: There were 94 male and 20 females patients with a male to female ratio of 4.7:1 and the median follow-up time was 54 months (3-117months). There were 51 patients dead till the last visit. Only 9 patients received RT alone (Group 1) and other patients received cisplatin based chemotherapy of different sequences. Concurrent chemoradiotherapy regimen (Group 2) was delivered in 37 patients, neoadjuvant chemotherapy + concurrent chemoradiotherapy regimen (Group 3) was delivered in 53 patients and concurrent chemoradiotherapy + adjuvant chemotherapy regimen (Group 4) was delivered in 15 patients. The 5-year overall survival (OS) rate was 48.5% of the whole population and were 16.7%, 54.2%, 72.3% and 80.0%, respectively (p = .001) of the four groups. The 5-year relapse-free survival (RFS) rates were 83.3%,77.2%,87.6% and 93.3% , respectively (p = .51). The 5-year metastasis-free survival (MFS) rates were 16.7%, 51.4%, 67.8% and 71.1%, respectively (p = .000). Conclusions: RT alone regimen was found to cause bad prognosis in N3 disease nasopharyngeal carcinoma patients. Concurrent chemoradiotherapy regimen improved the overall survival but was less effective than the neoadjuvant chemotherapy + concurrent chemoradiotherapy and concurrent chemoradiotherapy + adjuvant chemotherapy regimen.