BACKGROUND: Reirradiation of head and neck cancer is associated with high rates of locoregional failure and potentially severe treatment-related toxicity. We report our institutional experience of reirradiation using modern highly conformal radiotherapy approaches in patients with prior oropharyngeal radiation. METHODS: We reviewed patients receiving curative-intent reirradiation with intensity-modulated radiation therapy, stereotactic body radiation therapy, and proton beam radiotherapy at our institution from 1999 to 2019. Disease control, survival, and toxicity rates following reirradiation were determined. RESULTS: Sixty-nine patients were evaluated. Local control (LC), progression-free survival, and overall survival at 2 years following reirradiation were 77%, 35%, and 51%, respectively. Grade 3 or greater (G3+) late toxicities occurred in 46% of patients and 41% required feeding tube placement during or after reirradiation. CONCLUSIONS: In select patients with prior oropharyngeal radiation, highly conformal reirradiation offers acceptable LC, but G3+ toxicity and out-of-field failure rates remain high. These findings warrant continued evaluation of new multimodality approaches to improve oncologic outcomes.
BACKGROUND: Reirradiation of head and neck cancer is associated with high rates of locoregional failure and potentially severe treatment-related toxicity. We report our institutional experience of reirradiation using modern highly conformal radiotherapy approaches in patients with prior oropharyngeal radiation. METHODS: We reviewed patients receiving curative-intent reirradiation with intensity-modulated radiation therapy, stereotactic body radiation therapy, and proton beam radiotherapy at our institution from 1999 to 2019. Disease control, survival, and toxicity rates following reirradiation were determined. RESULTS: Sixty-nine patients were evaluated. Local control (LC), progression-free survival, and overall survival at 2 years following reirradiation were 77%, 35%, and 51%, respectively. Grade 3 or greater (G3+) late toxicities occurred in 46% of patients and 41% required feeding tube placement during or after reirradiation. CONCLUSIONS: In select patients with prior oropharyngeal radiation, highly conformal reirradiation offers acceptable LC, but G3+toxicity and out-of-field failure rates remain high. These findings warrant continued evaluation of new multimodality approaches to improve oncologic outcomes.
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Authors: G Brandon Gunn; Adam S Garden; Rong Ye; Noveen Ausat; Kristina R Dahlstrom; William H Morrison; C David Fuller; Jack Phan; Jay P Reddy; Shalin J Shah; Lauren L Mayo; Stephen G Chun; Gregory M Chronowski; Amy C Moreno; Jeffery N Myers; Ehab Y Hanna; Bita Esmaeli; Maura L Gillison; Renata Ferrarotto; Katherine A Hutcheson; Mark S Chambers; Lawrence E Ginsberg; Adel K El-Naggar; David I Rosenthal; Xiaorong Ronald Zhu; Steven J Frank Journal: Int J Part Ther Date: 2021-06-25