Ester Orlandi1,2, Pierluigi Bonomo3, Letizia Ferella2, Elisa D'Angelo4, Marta Maddalo5, Daniela Alterio6, Gabriele Infante7, Almalina Bacigalupo8, Angela Argenone9, Nicola Alessandro Iacovelli2, Isacco Desideri3, Bruno Meduri4, Luca Triggiani5, Stefania Volpe6,10, Liliana Belgioia8,11, Francesco Dionisi12, Domenico Attilio Romanello2,13, Carlo Fallai2, Rosalba Miceli7. 1. Radiotherapy 1 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 2. Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 3. Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. 4. Radiation Oncology Department, University Hospital of Modena, Modena, Italy. 5. Radiation Oncology Department, ASST Spedali Civili di Brescia-Brescia University, Brescia, Italy. 6. Division of Radiation Oncology, European Institute of Oncology IRCCS, Milan, Italy. 7. Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 8. Radiation Oncology Department, San Martino Hospital, Genoa, Italy. 9. Radiation Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione "GPascale", Naples, Italy. 10. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. 11. Health Science Department (DISSAL), University of Genoa, San Martino Hospital, Genoa, Italy. 12. Protontherapy Unit, APSS, Trento, Italy. 13. School of Medicine, University of Milan-Bicocca, Milan, Italy.
Abstract
BACKGROUND: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. METHODS: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. RESULTS: Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. CONCLUSION: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.
BACKGROUND: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. METHODS: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. RESULTS: Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. CONCLUSION: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.
Authors: Muhammad Shahid Iqbal; Nick West; Neil Richmond; Josef Kovarik; Isabel Gray; Nick Willis; David Morgan; Gozde Yazici; Mustafa Cengiz; Vinidh Paleri; Charles Kelly Journal: Br J Radiol Date: 2020-09-24 Impact factor: 3.039