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Review
. 2021 Jan;43(1):354-366.
doi: 10.1002/hed.26485. Epub 2020 Sep 30.

Radical external beam re-irradiation in the treatment of recurrent head and neck cancer: Critical review

Michaela Svajdova  1   2 , Pavol Dubinsky  3   4 , Tomas Kazda  2   5   6
Affiliations
Review

Radical external beam re-irradiation in the treatment of recurrent head and neck cancer: Critical review

Michaela Svajdova et al. Head Neck. 2021 Jan.

Abstract

Management of patients with recurrent head and neck cancer remains a challenge for the surgeon as well as the treating radiation oncologist. Even in the era of modern radiotherapy, the rate of severe toxicity remains high with unsatisfactory treatment results. Intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and heavy-ion irradiation have all emerged as highly conformal and precise techniques that offer many radiobiological advantages in various clinical situations. Although re-irradiation is now widespread in clinical practice, little is known about the differences in treatment response and toxicity using diverse re-irradiation techniques. In this review, we provide a comprehensive overview of the role of radiation therapy in recurrent or second primary head and neck cancer including patient selection, therapeutic outcome, and risk using different re-irradiation techniques. Critical review of published evidence on IMRT, SBRT, and heavy-ion full-dose re-irradiation is presented including data on locoregional control, overall survival, and toxicity.

Keywords: head and neck cancer; radiotherapy; re-irradiation; recurrence; toxicity.

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References

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