Conformal re-irradiation of recurrent and new primary head-and-neck cancer

Dawson, Laura A.; Myers, Larry L.; Bradford, Carol R.; Chepeha, D.; Hogikyan, Norman D.; Teknos, Ted; Terrell, Jeffrey E.; Wolf, Gregory T.; Eisbruch, Avraham

doi:10.1016/s0360-3016(01)01456-0

Cited by 109 publications

(91 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although there is evidence to warrant substantial concern regarding the toxicity resulting from reirradiation of the head and neck, a number of studies addressing survival and disease control rates with reirradiation (with or without chemotherapy) have demonstrated long-term survival in a small percentage of patients. 7,11,13,16,[24][25][26][27] In the current study, palliative patients were assessed separately from patients treated with curative intent because the survival rates and adverse events have clearly different implications for these 2 patient groups. The survival rate for our palliative patient group was poor, with a median survival of 6.2 months and no 2-year survivors.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11] When surgery is not an option or when salvage surgery is undertaken and the pathologic findings demonstrate a high risk of failure, reirradiation with or without the addition of chemotherapy may be considered for salvage treatment. 7,9,[12][13][14][15] Reirradiation may also be used for palliation in cases where the disease is not felt to be curable.…”

mentioning

confidence: 99%

“…7,9,[12][13][14][15] Reirradiation may also be used for palliation in cases where the disease is not felt to be curable. 11,16 The major concern with reirradiation that uses an effective tumor dose (>50-60 Gy 17,18 ) is the anticipated toxicity to normal tissues. 7,12,15,19 There are limited data on toxicity following reirradiation, particularly late toxicity, because the majority of patients do not survive long enough to be at risk for these toxicities.…”

mentioning

confidence: 99%

“…13,14,20 The reported rates of severe late complications following reirradiation range from 7% to 24%. 7,11,13,14,[16][17][18][20][21][22][23][24][25][26] The primary objective of this study was to investigate both the survival outcomes and adverse events in patients managed with reirradiation for head and neck cancer at the University of Iowa. Patients treated with palliative intent were assessed separately from patients treated with curative intent because survival rates and adverse events have clearly different implications for these 2 patient groups.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Outcomes following reirradiation of patients with head and neck cancer

et al. 2008

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Outcomes following reirradiation of patients with head and neck cancer

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Management of Recurrent Carcinoma of Nasopharynx is clinically challenging till date although nasopharyngeal tumors have more favorable prognosis compared to other head and neck sub-sites [1,2] .…”

Section: Discussionmentioning

confidence: 99%

Will Re-irradiation Alone Prevent Loco-regional Progression in Isolated Nodal Recurrence of Nasopharyngeal Carcinoma? - A Case Report

Prabaharan¹,

Marimuthu²,

Reddy³

et al. 2017

J Nasopharyng Carcinoma

View full text Add to dashboard Cite

Abstract:We report a case of 60 year old male with nasopharyngeal squamous cell carcinoma T2N3aMo treated with concurrent chemo-radiation 66Gy in 30 fractions with concurrent weekly carboplatin. On 1 year follow up, the patient had residual left level Ⅱnode, for which 6 cycles of Paclitaxel, cisplatin and 5-Fluorouracil (TPF) was given. Following one year disease free interval, the cancer recurred on same left level II region, for which left Modified Radical Neck Dissection was done. Post-operative re-irradiation 60 Gy in 30 fractions was given in view of extracapsular extension. After a disease free interval of 8 months, recurrence was found in nasopharynx and contralateral right level III nodal region. In our case, re-irradiation without chemotherapy has not improved disease free interval. Therefore, systemic chemotherapy along with re-irradiation should be considered for isolated nodal recurrence with extracapsular extension. (Fig. 1A). Concurrent chemoradiation with

show abstract

Larynx and Hypopharynx

et al. 2017

View full text Add to dashboard Cite

Summary The larynx and hypopharynx are common sites of origin for squamous cell cancers of the head and neck. The aim of treatment is to maximize disease control and survival with preservation of organ function and acceptably low acute and late morbidity. With recent emphasis on quality of life, the use of mutilating and extirpative surgery has rapidly declined worldwide, paving the way for conservative surgical techniques like lasers, endolaryngeal options and non‐surgical options. Platinum‐based concurrent definitive chemoradiation is generally considered the standard of care in the non‐surgical management of locally‐advanced laryngeal and hypopharyngeal cancer. Induction taxane‐based chemotherapy followed by platinum‐based concurrent chemoradiotherapy may be considered a reasonable alternative, although still investigational and unproven as equivalent to definitive concurrent chemoradiotherapy. Altered fractionation radiotherapy remains an option to intensify treatment if systemic treatments cannot be tolerated or are not available. The role of targeted therapy (cetuximab) continues to evolve with maximum benefit for patients ineligible for platinum‐based chemotherapy. Surgery still remains an important option for patients with cartilage involvement at initial diagnosis, poor response to neoadjuvant chemotherapy or residual/recurrent disease following an organ‐preservation protocol. Despite significant understanding of biology and important advances in management, outcomes for advanced laryngeal and hypopharyngeal cancers remain suboptimal. There is a need to identify robust prognostic and predictive factors to guide decision‐making, specify appropriate endpoints for organ and function preservation, and validate them in appropriately designed clinical trials prior to adoption in the clinic. This chapter provides a comprehensive summary of aetiology, clinical presentation, diagnosis, treatment and follow‐up, with a glimpse of current controversies, future advancements and research directions.

show abstract

Conformal re-irradiation of recurrent and new primary head-and-neck cancer

Cited by 109 publications

References 32 publications

Outcomes following reirradiation of patients with head and neck cancer

Outcomes following reirradiation of patients with head and neck cancer

Will Re-irradiation Alone Prevent Loco-regional Progression in Isolated Nodal Recurrence of Nasopharyngeal Carcinoma? - A Case Report

Larynx and Hypopharynx

Contact Info

Product

Resources

About