Arne Grün1, Thomas Kuhnt, Thorsten Schlomm, Heidi Olze, Volker Budach, Carmen Stromberger. 1. Department of Radiation Oncology and Radiotherapy, Charité-Universitätsmedizin Berlin,Campus Virchow-Klinikum; Charité CyberKnife Center Berlin, Charité-Universitätsmedizin Berlin,Campus Virchow-Klinikum; Klinik für Strahlentherapie Universitätsklinikum Leipzig; Department of Urology, Charité-Universitätsmedizin Berlin; Department of Otolaryngology, Charité-Universitätsmedizin Berlin,Campus Virchow-Klinikum.
Abstract
BACKGROUND: Recent advances in diagnostic methods and in radiotherapy now increasingly enable repeat radiotherapy with curative intent for the treatment of previously irradiated lesions. In this review, we present data on oncological outcomes and on acute and late sequelae, as far as these are currently known, in patients with head and neck tumors (HNT) or prostate cancer (PCa) who underwent repeat radiotherapy after prior radiotherapy with curative intent. METHODS: This review is based on clinical series with over 20 patients that were published between May 1998 and April 2018 (HNT) or between October 1998 and October 2018 (PCa) and were retrieved by a search in the PubMed database. RESULTS: Most of the clinical series retrieved were retrospective and uncontrolled. There were 16 studies that included 2678 patients with recurrent head and neck tumors, and 8 that included 245 patients with recurrent prostate cancer. In patients with squamous cell carcinoma of the head and neck, intensity-modulated radio - therapy (IMRT) and stereotactic body radiotherapy (SBRT) yielded three-year survival rates of 47-57% but also produced substantial acute and late adverse effects. Most of the studies concerning recurrent PCa involved small patient groups. In these studies, repeat radiotherapy with SBRT yielded tumor control rates of 40-80% after 11-24 months of follow-up, with only mild acute toxicity. CONCLUSION: Although no comparative studies are available, it seems that modern external beam radiotherapy techniques can be used for repeat radiotherapy of locally recurrent head and neck tumors with curative intent after careful patient selection. Repeat radiotherapy of PCa must still be considered experimental, but initial results from small-scale trials are encouraging. The long-term adverse effects cannot yet be accessed. Patients should be selected by an interdisciplinary tumor board. This type of treatment is generally carried out in a specialized center.
BACKGROUND: Recent advances in diagnostic methods and in radiotherapy now increasingly enable repeat radiotherapy with curative intent for the treatment of previously irradiated lesions. In this review, we present data on oncological outcomes and on acute and late sequelae, as far as these are currently known, in patients with head and neck tumors (HNT) or prostate cancer (PCa) who underwent repeat radiotherapy after prior radiotherapy with curative intent. METHODS: This review is based on clinical series with over 20 patients that were published between May 1998 and April 2018 (HNT) or between October 1998 and October 2018 (PCa) and were retrieved by a search in the PubMed database. RESULTS: Most of the clinical series retrieved were retrospective and uncontrolled. There were 16 studies that included 2678 patients with recurrent head and neck tumors, and 8 that included 245 patients with recurrent prostate cancer. In patients with squamous cell carcinoma of the head and neck, intensity-modulated radio - therapy (IMRT) and stereotactic body radiotherapy (SBRT) yielded three-year survival rates of 47-57% but also produced substantial acute and late adverse effects. Most of the studies concerning recurrent PCa involved small patient groups. In these studies, repeat radiotherapy with SBRT yielded tumor control rates of 40-80% after 11-24 months of follow-up, with only mild acute toxicity. CONCLUSION: Although no comparative studies are available, it seems that modern external beam radiotherapy techniques can be used for repeat radiotherapy of locally recurrent head and neck tumors with curative intent after careful patient selection. Repeat radiotherapy of PCa must still be considered experimental, but initial results from small-scale trials are encouraging. The long-term adverse effects cannot yet be accessed. Patients should be selected by an interdisciplinary tumor board. This type of treatment is generally carried out in a specialized center.
Authors: Oscar S H Chan; Henry C K Sze; Michael C H Lee; Lucy L K Chan; Amy T Y Chang; Sarah W M Lee; Wai Man Hung; Anne W M Lee; Wai Tong Ng Journal: Head Neck Date: 2016-11-29 Impact factor: 3.147
Authors: G Janoray; A Reynaud-Bougnoux; A Ruffier-Loubière; G Bernadou; Y Pointreau; G Calais Journal: Cancer Radiother Date: 2016-06-21 Impact factor: 1.018
Authors: John A Vargo; Matthew C Ward; Jimmy J Caudell; Nadeem Riaz; Neal E Dunlap; Derek Isrow; Sara J Zakem; Joshua Dault; Musaddiq J Awan; Kristin A Higgins; Comron Hassanadeh; Jonathan J Beitler; Chandana A Reddy; Samuel Marcrom; Drexell H Boggs; James A Bonner; Min Yao; Mitchell Machtay; Farzan Siddiqui; Andy M Trotti; Nancy Y Lee; Shlomo A Koyfman; Robert L Ferris; Dwight E Heron Journal: Int J Radiat Oncol Biol Phys Date: 2017-04-24 Impact factor: 7.038
Authors: Eric F Lartigau; Emmanuelle Tresch; Juliette Thariat; Pierre Graff; Bernard Coche-Dequeant; Karen Benezery; Luis Schiappacasse; Marian Degardin; Pierre-Yves Bondiau; Didier Peiffert; Jean-Louis Lefebvre; Thomas Lacornerie; Andrew Kramar Journal: Radiother Oncol Date: 2013-11-18 Impact factor: 6.280
Authors: Thomas Leroy; Thomas Lacornerie; Emilie Bogart; Philippe Nickers; Eric Lartigau; David Pasquier Journal: Radiat Oncol Date: 2017-06-09 Impact factor: 3.481
Authors: Leszek Miszczyk; Małgorzata Stąpór-Fudzińska; Marcin Miszczyk; Bogusław Maciejewski; Andrzej Tukiendorf Journal: Technol Cancer Res Treat Date: 2018-01-01
Authors: Matti Sievert; Miguel Goncalves; Benedicta Binder; Sarina K Mueller; Robin Rupp; Michael Koch; Stephan Dürr; Maximilian Traxdorf; Markus Hecht; Heinrich Iro; Antoniu-Oreste Gostian Journal: HNO Date: 2021-05-21 Impact factor: 1.284
Authors: Matti Sievert; Miguel Goncalves; Benedicta Binder; Sarina K Mueller; Robin Rupp; Michael Koch; Stephan Dürr; Maximilian Traxdorf; Markus Hecht; Heinrich Iro; Antoniu-Oreste Gostian Journal: HNO Date: 2021-04-09 Impact factor: 1.284