PURPOSE: To evaluate re-irradiation using IMRT for recurrent and second primary head and neck cancer in previously irradiated territory. MATERIALS AND METHODS: Between 1997 and 2008, 84 patients with recurrent and second primary head and neck cancer were treated with IMRT to a median dose of 69 Gy. Median time interval between initial radiotherapy and re-irradiation was 49.5 (5.2-298.3) months. Salvage surgery preceded re-irradiation in 19 patients; 17 patients received concurrent chemotherapy. RESULTS: Median follow-up of living patients was 19.8 (1.9-76.1) months. Five-year locoregional control and overall survival were 40% and 20%, respectively. Five-year disease-specific survival and disease-free survival were 29% and 15%, respectively. Stage T4 (p=0.015), time interval between initial treatment and re-irradiation (p=0.011) and hypopharyngeal cancer (p=0.013) were independent prognostic factors for worse overall survival in multivariate analysis. Twenty-six and 11 patients developed Grade 3 acute and late toxicity, respectively. No Grade 5 acute toxicity was encountered. There were 2 fatal vascular ruptures during follow-up. CONCLUSIONS: High-dose IMRT for recurrent and second primary head and neck cancer in previously irradiated territory leads to approximately 20% long-term survival in a non-selected patient population. Identification of patients who would benefit most of curative IMRT is warranted.
PURPOSE: To evaluate re-irradiation using IMRT for recurrent and second primary head and neck cancer in previously irradiated territory. MATERIALS AND METHODS: Between 1997 and 2008, 84 patients with recurrent and second primary head and neck cancer were treated with IMRT to a median dose of 69 Gy. Median time interval between initial radiotherapy and re-irradiation was 49.5 (5.2-298.3) months. Salvage surgery preceded re-irradiation in 19 patients; 17 patients received concurrent chemotherapy. RESULTS: Median follow-up of living patients was 19.8 (1.9-76.1) months. Five-year locoregional control and overall survival were 40% and 20%, respectively. Five-year disease-specific survival and disease-free survival were 29% and 15%, respectively. Stage T4 (p=0.015), time interval between initial treatment and re-irradiation (p=0.011) and hypopharyngeal cancer (p=0.013) were independent prognostic factors for worse overall survival in multivariate analysis. Twenty-six and 11 patients developed Grade 3 acute and late toxicity, respectively. No Grade 5 acute toxicity was encountered. There were 2 fatal vascular ruptures during follow-up. CONCLUSIONS: High-dose IMRT for recurrent and second primary head and neck cancer in previously irradiated territory leads to approximately 20% long-term survival in a non-selected patient population. Identification of patients who would benefit most of curative IMRT is warranted.
Authors: F Puebla; J L Lopez Guerra; J M Garcia Ramirez; R Matute; I Marrone; C Miguez; D Sevillano; A Sanchez-Reyes; E Rivin Del Campo; J M Praena-Fernandez; I Azinovic Journal: Clin Transl Oncol Date: 2015-06-25 Impact factor: 3.405
Authors: John P Leonetti; Jeffrey R Weishaar; David Gannon; Grant A Harmon; Alec Block; Douglas E Anderson Journal: J Neurooncol Date: 2020-05-11 Impact factor: 4.130
Authors: N Oker; P Lang; D Bresson; B George; J-P Guichard; M Wassef; E Sauvaget; S Froelich; R Kania; P Herman Journal: Eur Arch Otorhinolaryngol Date: 2014-04-16 Impact factor: 2.503
Authors: V Rudzianskas; A Inciura; E Juozaityte; M Rudzianskiene; R Kubilius; S Vaitkus; M Kaseta; D Adliene Journal: Acta Otorhinolaryngol Ital Date: 2012-10 Impact factor: 2.124