Outcomes following reirradiation of patients with head and neck cancer

Goldstein, David P.; Yao, Min; Chamberlin, G. Parker; Nguyễn, Thanh Xuân; Funk, Gerry F.

doi:10.1002/hed.20786

Cited by 34 publications

(25 citation statements)

References 35 publications

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“…The prevalence and the severity of complications depend on the modality of radiation, the site irradiated, the time interval between the radiation treatments, and the rate of long-term survival. Complication rates vary from 7-50% but are higher for re-irradiation of the nasopharynx due to its proximity to brain, cranial nerves, and the visual system [8,9,15,18,20,26]. Our results are in agreement with results from the literature.…”

Section: Discussionsupporting

confidence: 83%

Outcome after Re-Irradiation of Head and Neck Cancer Patients

et al. 2010

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Section: Discussionsupporting

confidence: 83%

Outcome after Re-Irradiation of Head and Neck Cancer Patients

et al. 2010

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“…Elderly patients with oral tongue cancer can benefit from curative brachytherapy and contraindications should be based on the physical and psychological status of the individual patients, as with younger patients [12][13][14] Cs sources, can be used to treat elderly patients with physical or mental disabilities who are contraindicated for surgical treatment. By providing comprehensive care to patients with malignancies of the head and neck, clinicians can increase the likelihood that patients and their families will be able to obtain the best possible outcomes [15]. Now that good local control of tongue cancer has come to be expected for elderly patients, treatment of neck node metastasis following successful brachytherapy for tongue cancer has become the main problem [6].…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy for tongue cancer in the very elderly is an alternative to external beam radiation

Khalilur

Hayashi²,

Shibuya³

2011

BJR

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Background: The result of curative treatment for very elderly patients with tongue carcinoma has not been reported to date. We retrospectively reviewed the results of brachytherapy in 125 the patients aged over 75 years. Methods: The results of brachytherapy in 125 patients, 75 years old or older, with Stage I or II squamous cell carcinoma of the oral tongue were reviewed. The 125 cases consisted of 31 Stage I and 94 Stage II cases; 67 patients were under 80 years old and 58 were over 80 years old. All patients were treated using low-dose-rate brachytherapy (

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“…The definition of the targets varied in these studies, ranging from the recurrent tumor as well as the mucosal surfaces and lymph node areas at risk of sub-clinical disease (14,17,19), to studies limiting the targets to the recurrent tumor with various margins around the tumor (10–13, 16). In the typical series, the decision about the targets varied depending on the treating radiation oncologist (13b).…”

Section: Introductionmentioning

confidence: 99%

The Pattern of Failure After Reirradiation of Recurrent Squamous Cell Head and Neck Cancer: Implications for Defining the Targets

Popovtzer

Gluck

Chepeha

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

127

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Purpose Re-irradiation (re-RT) of recurrent head and neck cancer (HNC) may achieve long term disease control in some patients, at the expense of high rates of late sequelae. Limiting the re-RT targets to the recurrent gross tumor volume (rGTV) would reduce the volumes of re-irradiated tissues, however, its effect on tumor recurrence pattern is unknown. Methods Retrospective review of 66 patients who underwent curative-intent re-RT for non-resectable recurrent or second primary mucosal squamous cell HNC. Treatment was delivered with 3-dimensional conformal (3D) RT or intensity modulated RT (IMRT). The targets in all patients consisted of the rGTVs with tight (0.5 cm) margins, with no intent to treat prophylactically lymph nodes or sub-clinical disease in the vicinity of the rGTVs. The sites of local-regional failures (LRFs) were determined using imaging at the time of failure, and were compared to the rGTVs. Results Median re-RT dose was 68 Gy. 47 patients (71%) received concomitant chemotherapy and 31 (47%) received hyperfractionated, accelerated RT. At a median follow up 42 month, 16 (23%) are alive and free of disease. Fifty patients (77%) had a third recurrence or persistent disease, including 47 LRFs. All LRFs occurred within the rGTVs except for two (4%) (95% C.I. 0; 11 %). Nineteen patients (29%) had grade ≥3 late complications, mostly dysphagia (12 patients). Conclusion Almost all LRFs occurred within the re-irradiated rGTVs despite avoiding prophylactic RT of tissue at risk of subclinical disease. These results support confining the re-RT targets to the rGTVs to reduce re-irradiated tissue volumes.

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Outcomes following reirradiation of patients with head and neck cancer

Abstract: A second course of radiotherapy in patients with head and neck cancer should be offered with a clear understanding that survival is poor and many of these patients will suffer severe radiation-related or disease-related insults to their quality of life during and after treatment.

Cited by 34 publications

References 35 publications

Outcome after Re-Irradiation of Head and Neck Cancer Patients

Outcome after Re-Irradiation of Head and Neck Cancer Patients

Brachytherapy for tongue cancer in the very elderly is an alternative to external beam radiation

The Pattern of Failure After Reirradiation of Recurrent Squamous Cell Head and Neck Cancer: Implications for Defining the Targets

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