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Multicenter Study
. 2022 Oct;11(19):3593-3601.
doi: 10.1002/cam4.4741. Epub 2022 Apr 7.

Multicenter study of re-irradiation using carbon-ions for head and neck malignancies after photon radiotherapy

Daiki Takahashi  1 , Yusuke Demizu  1   2 , Masashi Koto  3 , Nobuteru Kubo  4 , Hiroaki Suefuji  5 , Hiroaki Ikawa  3 , Tatsuya Ohno  4 , Yoshiyuki Shioyama  5 , Tomoaki Okimoto  1 , Hiroshi Tsuji  3 ; Japan Carbon-Ion Radiation Oncology Study Group
Affiliations
Multicenter Study

Multicenter study of re-irradiation using carbon-ions for head and neck malignancies after photon radiotherapy

Daiki Takahashi et al. Cancer Med. 2022 Oct.

Abstract

Purpose: The goal of this multicenter retrospective study of patients with head and neck malignancies was to evaluate the efficacy and safety of carbon-ion (C-ion) radiotherapy (RT) after photon RT.

Methods: We enrolled 56 patients with head and neck malignancies who underwent re-irradiation (re-RT) using C-ions between November 2003 and March 2019, treated previously with photon RT. The tumors at re-RT were located in the sinonasal cavities (n = 20, 35.7%), skull base (n = 12, 21.4%), and orbit (n = 7, 12.5%). The tumors at the initial RT were located in the sinonasal cavities (n = 13, 23.2%), skull base (n = 9, 16.1%), and orbit (n = 9, 16.1%). The median period between the initial RT and re-RT was 41 (4-568) months. The most common histology of re-RT was squamous cell carcinoma (n = 11, 19.6%). The most commonly used protocol was 57.6 Gy (relative biological effectiveness) in 16 fractions (n = 23, 41.1%). Surgery preceded re-RT in three patients (5.4%). One patient with malignant melanoma received concurrent chemotherapy.

Results: The 2-year local control, progression-free survival, and overall survival rates were 66.5%, 36.9%, and 67.9%, respectively. The median follow-up time was 28 months. Two patients (3.6%) developed grade ≥ 3 acute toxicities, and 14 (25.0%) developed grade ≥ 3 late toxicities. A single patient had confirmed grade 5 dermatitis with infection.

Conclusion: Re-RT using C-ions for head and neck malignancies after photon RT is an effective treatment with tolerable toxicity.

Keywords: clinical cancer research; head and neck; multicenter study; salvage treatment.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier curves of local control, progression‐free survival, and overall survival following re‐irradiation using carbon ions for head and neck malignancies. LC, local control; PFS, progression‐free survival; OS, overall survival
FIGURE 2
FIGURE 2
Cumulative incidence of grade ≥3 late toxicities with the Kaplan–Meier method
See this image and copyright information in PMC

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