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. 2017 Jul-Aug;22(4):331-339.
doi: 10.1016/j.rpor.2017.05.001. Epub 2017 Jun 7.

Reirradiation with IMRT for recurrent head and neck cancer: A single-institutional report on disease control, survival, and toxicity

Parveen Ahlawat  1 , Sheh Rawat  2 , Anjali Kakria  1 , Bharti Devnani  3 , Inderjit Kaur Wahi  1 , David K Simson  4
Affiliations

Reirradiation with IMRT for recurrent head and neck cancer: A single-institutional report on disease control, survival, and toxicity

Parveen Ahlawat et al. Rep Pract Oncol Radiother. 2017 Jul-Aug.

Abstract

Aim: To study and explores the feasibility and efficacy of re-irradiation (Re-RT) for locally recurrent head and neck cancer (HNC) and second primary (SP) malignancies.

Background: The most common form of treatment failure after radiotherapy (RT) for HNC is loco-regional recurrence (LRR), and around 20-50% of patients develop LRR. Re-irradiation (Re-RT) has been the primary standard of care in the last decade for unresectable locally recurrent/SP HNC.

Materials and methods: It was a retrospective analysis in which we reviewed the medical records of 51 consecutive patients who had received Re-RT to the head and neck region at our institute between 2006 and 2015.

Results: Forty-eight patients were included for assessment of acute and late toxicities, response evaluation at 3 months post Re-RT, and analyses of locoregional control (LRC) and overall survival (OS). The median LRC was 11.2 months, and at 2 and 5 years the LRC rates were 41% and 21.2%, respectively. A multivariate analysis revealed two factors: initial surgical resection performed prior to Re-RT, and achievement of CR at 3 months after completion of Re-RT to be significantly associated with a better median LRC. The median OS was 28.2 months, and at 1, 2, and 5 years, OS were 71.1%, 55.9% and 18%, respectively. A multivariate analysis revealed initial surgical resection performed prior to Re-RT, and achievement of CR at 3 months post completion of Re-RT being only two factors significantly associated with a better median OS. Acute toxicity reports showed that no patients developed grade 5 toxicity, and 2 patients developed grade 4 acute toxicities.

Conclusion: Re-RT for the treatment of recurrent/SP head and neck tumors is feasible and effective, with acceptable toxicity. However, appropriate patient selection criteria are highly important in determining survival and treatment outcomes.

Keywords: Head neck; Intensity modulated radiotherapy; Recurrent; Reirradiation; Salvage.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier estimates for locoregional control with reirradiation for recurrent/second primary head and neck cancer.
Fig. 2
Fig. 2
Kaplan–Meier estimates for overall survival with reirradiation for recurrent/second primary head and neck cancer.
See this image and copyright information in PMC

References

    1. Bourhis J., Le Maître A., Baujat B. Individual patients’ data meta-analyses in head and neck cancer. Curr Opin Oncol. 2007;19:188. - PubMed
    1. Bernier J., Domenge C., Ozsahin M. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med. 2004;350:1945. - PubMed
    1. Cooper J.S., Pajak T.F., Forastiere A.A. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med. 2004;350:1937. - PubMed
    1. Kim S.Y., Roh J.L., Yeo N.K. Combined 18F-fluorodeoxyglucose-positron emission tomography and computed tomography as a primary screening method for detecting second primary cancers and distant metastases in patients with head and neck cancer. Ann Oncol. 2007;18:1698. - PubMed
    1. Lee D.H., Roh J.L., Baek S. Second cancer incidence, risk factor, and specific mortality in head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg. 2013;149(4):579–586. - PubMed

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