open access

Vol 22, No 4 (2017)
Original research articles
Published online: 2017-07-01
Submitted: 2016-11-18
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Reirradiation with IMRT for recurrent head and neck cancer: A single-institutional report on disease control, survival, and toxicity

Parveen Ahlawat, Sheh Rawat, Anjali Kakria, Bharti Devnani, Inderjit Kaur Wahi, David K Simson
DOI: 10.1016/j.rpor.2017.05.001
·
Rep Pract Oncol Radiother 2017;22(4):331-339.

open access

Vol 22, No 4 (2017)
Original research articles
Published online: 2017-07-01
Submitted: 2016-11-18

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.

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.

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Keywords

Head neck; Reirradiation; Intensity modulated radiotherapy; Recurrent; Salvage

About this article
Title

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

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 22, No 4 (2017)

Pages

331-339

Published online

2017-07-01

DOI

10.1016/j.rpor.2017.05.001

Bibliographic record

Rep Pract Oncol Radiother 2017;22(4):331-339.

Keywords

Head neck
Reirradiation
Intensity modulated radiotherapy
Recurrent
Salvage

Authors

Parveen Ahlawat
Sheh Rawat
Anjali Kakria
Bharti Devnani
Inderjit Kaur Wahi
David K Simson

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