Toxicity and survival outcomes of hyperfractionated split-course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers

Head Neck. 2009 Apr;31(4):493-502. doi: 10.1002/hed.20986.

Abstract

Background: : Reirradiation of locoregionally recurrent, previously irradiated head/neck cancer may be considered in situations of unresectability, medical inoperability, or adverse pathologic features found at salvage resection.

Methods: : Retrospective cohort analysis of toxicity and survival outcomes in locoregionally recurrent, previously irradiated patients with head/neck cancer treated with hyperfractionated split-course radiotherapy and concurrent chemotherapy.

Results: : Between March 1998 and September 2006, 39 patients initiated reirradiation at median of 2.3 years (range, 0.5-19) following prior radiotherapy. At median survivor follow-up of 24.5 months (range, 3-63.9), 10 patients are alive without evidence of disease. Median survival is 19.0 months, with estimated 1-, 2-, and 3-year overall survivals of 60.1%, 45.1%, and 22.7%, respectively. Locoregional failure was the predominant site of postreirradiation recurrence. Male sex, total radiotherapy dose, cycles of chemotherapy completed, and clinical response were associated with improved overall survival.

Conclusions: : Reirradiation can offer long-term survival for patients with recurrent, previously irradiated head/neck cancers.

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Combined Modality Therapy
  • Dose Fractionation, Radiation*
  • Female
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / radiotherapy
  • Radiation Injuries / etiology*
  • Retreatment
  • Survival Rate

Substances

  • Antineoplastic Agents