BACKGROUND AND PURPOSE: This study was undertaken to determine the feasibility of salvage surgery and PHDRB in patients with previously irradiated, recurrent head and neck cancer or second primary tumors arising in a previously irradiated field. METHODS AND MATERIALS: Sixty-three patients were treated with surgical resection and PHDRB. The PHDRB dose was 4Gy b.i.d.×8 (32Gy) for R0 resections and 4Gy b.i.d.×10 (40Gy) for R1 resections, respectively. Further external beam radiotherapy or chemotherapy was not given. RESULTS: Resections were categorized as R0 in 7 patients (11.1%) and R1 in 56 (88.9%). Thirty-four patients with R1 resections (54.0%) had microscopically positive margins, and 22 patients (34.9%) had close margins. Thirty-two patients (50.8%) developed RTOG grade 3 or greater adverse events including 3 fatal events. After a median follow-up of 6.8years, the 5-year locoregional control rate and 5-year overall survival rates were 55.0% and 35.6%, respectively. CONCLUSIONS: Surgical resection and PHDRB is a successful treatment strategy in selected patients with previously irradiated head and neck cancer. Long-term locoregional control can be achieved in a substantial number of cases despite a high rate of inadequate surgical resections although at the expense of substantial toxicity.
BACKGROUND AND PURPOSE: This study was undertaken to determine the feasibility of salvage surgery and PHDRB in patients with previously irradiated, recurrent head and neck cancer or second primary tumors arising in a previously irradiated field. METHODS AND MATERIALS: Sixty-three patients were treated with surgical resection and PHDRB. The PHDRB dose was 4Gy b.i.d.×8 (32Gy) for R0 resections and 4Gy b.i.d.×10 (40Gy) for R1 resections, respectively. Further external beam radiotherapy or chemotherapy was not given. RESULTS: Resections were categorized as R0 in 7 patients (11.1%) and R1 in 56 (88.9%). Thirty-four patients with R1 resections (54.0%) had microscopically positive margins, and 22 patients (34.9%) had close margins. Thirty-two patients (50.8%) developed RTOG grade 3 or greater adverse events including 3 fatal events. After a median follow-up of 6.8years, the 5-year locoregional control rate and 5-year overall survival rates were 55.0% and 35.6%, respectively. CONCLUSIONS: Surgical resection and PHDRB is a successful treatment strategy in selected patients with previously irradiated head and neck cancer. Long-term locoregional control can be achieved in a substantial number of cases despite a high rate of inadequate surgical resections although at the expense of substantial toxicity.
Authors: Julianna Rodin; Voichita Bar-Ad; David Cognetti; Joseph Curry; Jennifer Johnson; Chad Zender; Laura Doyle; David Kutler; Benjamin Leiby; William Keane; Adam Luginbuhl Journal: J Contemp Brachytherapy Date: 2018-10-31
Authors: Michael Kharouta; Chad Zender; Tarun Podder; Rod Rezaee; Pierre Lavertu; Nicole Fowler; Jason Thuener; Shawn Li; Kate Clancy; Zhengzheng Xu; Min Yao Journal: Front Oncol Date: 2021-03-18 Impact factor: 6.244
Authors: Adam Luginbuhl; Alyssa Calder; David Kutler; Chad Zender; Trisha Wise-Draper; Jena Patel; Michael Cheng; Vidhya Karivedu; Tingting Zhan; Bhupesh Parashar; Shuchi Gulati; Min Yao; Pierre Lavertu; Vinita Takiar; Alice Tang; Jennifer Johnson; William Keane; Joseph Curry; David Cognetti; Voichita Bar-Ad Journal: Front Oncol Date: 2021-11-26 Impact factor: 6.244
Authors: Amit Bahl; Roshan K Verma; Naresh K Panda; Arun S Oinam; Jerry R John; Satinder Kaur; Pramod Kumar; Sushmita Ghoshal; Gaurav Trivedi; Jaimanti Bakshi Journal: BJR Case Rep Date: 2021-04-12