Thomas Held1, Paul Windisch1, Sati Akbaba1, Kristin Lang1, Rami El Shafie1, Denise Bernhardt1, Peter Plinkert2, Steffen Kargus3, Stefan Rieken4, Klaus Herfarth4, Jürgen Debus4, Sebastian Adeberg5. 1. Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany. 2. Department of Otorhinolaryngology, University of Heidelberg, Heidelberg, Germany. 3. Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany. 4. Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany; German Cancer Consortium (DKTK), partner site Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany. 5. Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany; German Cancer Consortium (DKTK), partner site Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address: sebastian.adeberg@med.uni-heidelberg.de.
Abstract
PURPOSE: This study aimed to assess the feasibility of carbon ion reirradiation (CIR) for recurrent head and neck cancer (HNC). METHODS AND MATERIALS: This retrospective study included 229 patients with recurrent HNC who were treated with CIR between 2010 and 2017. We assessed progression-free survival, overall survival, pattern of failure, and toxicity. Of the primary tumors, 54.1% were adenoid cystic carcinomas, 26.2% were squamous cell carcinomas, 8.3% were adenocarcinomas, and 11.4% were other tumor entities. RESULTS: The median radiation therapy interval was 3.9 years (range, 0.3-46.5 years), and patients received a median dose of 51 Gy (relative biological effectiveness [RBE]; range, 30-66 Gy [RBE]) in 3 Gy (RBE) fractions. The median cumulative lifetime dose after CIR was 132.8 Gy (range, 88.8-155.0 Gy). The median local progression-free survival after CIR was 24.2 months (95% confidence interval, 19.4-29.0 months), and the median overall survival was 26.1 months (95% confidence interval, 21.9-30.3 months). Serious acute toxicity (grade ≥3) after CIR included laryngeal edema, grade 4 (n = 2; 0.9%); dysphagia, grade 3 (n = 3; 1.3%); fistula, grade 3 (n = 1; 0.4%); and impaired hearing, grade 3 (n = 1; 0.4%). Late toxicities of grades 3 or higher (n = 18; 14.5%) included central nervous system necrosis, grades 4/3 (n = 1; 0.8%/n = 5; 4.0%); optic nerve disorder, grades 4/3 (n = 2; 1.6%/n = 2; 1.6%); impaired hearing, grade 3 (n = 5; 4.0%), osteonecrosis, grade 3 (n = 1; 0.8%); and carotid blowout, grade 4 (n = 1; 0.8%). CONCLUSIONS: In patients with locally recurrent HNC, CIR was a feasible, effective treatment with acceptable toxicity and good local control. Thus, CIR represented a valuable alternative to surgical salvage and palliative chemotherapy in selected patients.
PURPOSE: This study aimed to assess the feasibility of carbon ion reirradiation (CIR) for recurrent head and neck cancer (HNC). METHODS AND MATERIALS: This retrospective study included 229 patients with recurrent HNC who were treated with CIR between 2010 and 2017. We assessed progression-free survival, overall survival, pattern of failure, and toxicity. Of the primary tumors, 54.1% were adenoid cystic carcinomas, 26.2% were squamous cell carcinomas, 8.3% were adenocarcinomas, and 11.4% were other tumor entities. RESULTS: The median radiation therapy interval was 3.9 years (range, 0.3-46.5 years), and patients received a median dose of 51 Gy (relative biological effectiveness [RBE]; range, 30-66 Gy [RBE]) in 3 Gy (RBE) fractions. The median cumulative lifetime dose after CIR was 132.8 Gy (range, 88.8-155.0 Gy). The median local progression-free survival after CIR was 24.2 months (95% confidence interval, 19.4-29.0 months), and the median overall survival was 26.1 months (95% confidence interval, 21.9-30.3 months). Serious acute toxicity (grade ≥3) after CIR included laryngeal edema, grade 4 (n = 2; 0.9%); dysphagia, grade 3 (n = 3; 1.3%); fistula, grade 3 (n = 1; 0.4%); and impaired hearing, grade 3 (n = 1; 0.4%). Late toxicities of grades 3 or higher (n = 18; 14.5%) included central nervous system necrosis, grades 4/3 (n = 1; 0.8%/n = 5; 4.0%); optic nerve disorder, grades 4/3 (n = 2; 1.6%/n = 2; 1.6%); impaired hearing, grade 3 (n = 5; 4.0%), osteonecrosis, grade 3 (n = 1; 0.8%); and carotid blowout, grade 4 (n = 1; 0.8%). CONCLUSIONS: In patients with locally recurrent HNC, CIR was a feasible, effective treatment with acceptable toxicity and good local control. Thus, CIR represented a valuable alternative to surgical salvage and palliative chemotherapy in selected patients.
Authors: Thomas Held; Thomas Tessonnier; Henrik Franke; Sebastian Regnery; Lukas Bauer; Katharina Weusthof; Semi Harrabi; Klaus Herfarth; Andrea Mairani; Jürgen Debus; Sebastian Adeberg Journal: Radiat Oncol Date: 2022-07-08 Impact factor: 4.309
Authors: Thomas Held; Semi B Harrabi; Kristin Lang; Sati Akbaba; Paul Windisch; Denise Bernhardt; Stefan Rieken; Klaus Herfarth; Jürgen Debus; Sebastian Adeberg Journal: Cancers (Basel) Date: 2019-12-13 Impact factor: 6.639
Authors: Fabian Eberle; Rita Engenhart-Cabillic; Markus M Schymalla; Christoph Dumke; Ulrike Schötz; Florentine S B Subtil; Kilian-Simon Baumann; Boris A Stuck; Christine Langer; Alexandra D Jensen; Henrik Hauswald; Stefan Lautenschläger Journal: Front Oncol Date: 2022-02-15 Impact factor: 6.244
Authors: Mauricio E Gamez; Samir H Patel; Lisa A McGee; Terence T Sio; Mark McDonald; Jack Phan; Daniel J Ma; Robert L Foote; Jean-Claude M Rwigema Journal: Int J Part Ther Date: 2021-06-25
Authors: Alexander Rühle; Tanja Sprave; Tobias Kalckreuth; Raluca Stoian; Erik Haehl; Constantinos Zamboglou; Roland Laszig; Andreas Knopf; Anca-Ligia Grosu; Nils H Nicolay Journal: Radiat Oncol Date: 2020-04-16 Impact factor: 3.481
Authors: Thomas Held; Kristin Lang; Sebastian Regnery; Katharina Weusthof; Adriane Hommertgen; Cornelia Jäkel; Eric Tonndorf-Martini; Johannes Krisam; Peter Plinkert; Karim Zaoui; Christian Freudlsperger; Julius Moratin; Jürgen Krauss; Semi B Harrabi; Klaus Herfarth; Jürgen Debus; Sebastian Adeberg Journal: Radiat Oncol Date: 2020-08-05 Impact factor: 3.481