Retreatment of Recurrent or Second Primary Head and Neck Cancer After Prior Radiation: Executive Summary of the American Radium Society Appropriate Use Criteria

Ward, Matthew C.; Koyfman, Shlomo A.; Bakst, Richard L.; Margalit, Danielle N.; Beadle, Beth M.; Beitler, Jonathan J.; Chang, Steven S.; Cooper, Jay S.; Galloway, Thomas J.; Ridge, John A.; Robbins, Jared R.; Sacco, Assuntina G.; Tsai, C. Jillian; Yom, Sue S.; Siddiqui, Farzan

doi:10.1016/j.ijrobp.2022.03.034

Cited by 37 publications

(27 citation statements)

References 271 publications

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“…The results showed that patients with good ECOG PS and rRT doses above 50 Gy (EQD2) had median longer OS (17.8 months vs. 11.7 months, p < 0.01) and PFS (9.6 months vs. 6.8 months, p < 0.01) compared to those with poor ECOG PS and rRT below 50 Gy (EQD2) (p < 0.01) [22]. These findings provide important information for clinicians who are considering rRT treatment options for patients with rHNC [9,13,14].…”

Section: Discussionmentioning

confidence: 76%

“…In this study, the factors that were found to be associated with better OS included good PS (ECOG 0) and young age (below 52 years). Furthermore, the study results showed that improved DFS was observed in patients who had a PS of ECOG 0 and received a rRT dose > 60 Gys [14]. A higher radiotherapy dose was typically associated with improved local control of rHNC.…”

Section: Discussionmentioning

confidence: 90%

“…The advantages of rRT should outweigh the associated risks of such treatment. Patients require a multidisciplinary evaluation to determine the best management strategy [13,14]. Salvage surgery is the preferred choice for resectable cases, either with or without adjuvant rRT (+/− concurrent chemotherapy) as indicated by postoperative histopathological findings.…”

Section: Introductionmentioning

confidence: 99%

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Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

Mohamad

Hejleh

Abdelqader

et al. 2023

JCM

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Salvage re-irradiation (rRT) for patients with locoregionally recurrent head and neck cancer (rHNC) remains challenging. A retrospective analysis was performed on 49 patients who received rRT between 2011 and 2018. The co-primary endpoint of the study was 2-year freedom from cancer recurrence rate (FCRR) and overall survival (OS), and secondary endpoints were 2-year disease-free survival (DFS), local failure (LF), regional failure (RF), distant metastases (DM), and RTOG grade 3 ≥ late toxicities. Adjuvant and definitive rRT were delivered to 22 and 27 patients, respectively. A total of 91% of patients were managed with conventional re-RT and 71% of patients received concurrent chemotherapy. The median follow-up after rRT was 30 months. The 2-year FCRR, OS, DFS, LF, RF, and DM were 64%, 51%, 28%, 32%, 9%, and 39% respectively. MVA showed that poor performance status (PS: 1–2 vs. 0) and age > 52 years were predictive of worse OS. In comparison, poor PS (1–2 vs. 0) and total dose of rRT < 60 Gy were predictive of worse DFS. Late RTOG toxicity of grade 3 ≥ was reported in nine (18.3%) patients. FCRR at 2 years after salvage rRT for rHNC was higher than other traditional endpoints and could be an important endpoint to be included in future rRT studies. rRT for rHNC at our cohort was relatively successful, with a manageable level of late severe toxicity. Replacing this approach in other developing countries is a viable option.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

Mohamad

Hejleh

Abdelqader

et al. 2023

JCM

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“…The treatment of recurrent or second primary malignancies in areas that have been previously irradiated is complex. Re‐irradiation may be a viable option for these patients, but it also increases the risk of disease progression and normal tissue toxicity, which may explain the poorer prognosis of patients with SHNCs in the RT group 28 . More research is needed to discover the genetic basis underlying these disparities.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and risk of second primary malignancies after radiotherapy in major salivary gland carcinomas: A retrospective study using SEER database

Feng,

Qian,

Guo

et al. 2024

Head & Neck

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ObjectiveTo investigate the effectiveness of radiotherapy and its association with second primary malignancies (SPMs) risk in major salivary gland carcinomas (MSGCs) patients.MethodsCohort 1 included 7274 surgically treated MSGC patients from the Surveillance, Epidemiology, and End Results database, assessing the effectiveness of radiotherapy. Cohort 2 (n = 4213) comprised patients with ≥5‐year survival in Cohort 1 to study SPMs.ResultsRadiotherapy decreased overall survival in MSGCs patients, but improved it in high‐grade MSGCs. Cumulative SPMs incidences at 25 years were 16.5% in the radiotherapy (RT) group compared to 14.5% in the non‐radiotherapy (NRT) group. For second head and neck carcinomas (SHNCs), incidences were 3.4% in RT versus 1.6% in NRT. Radiotherapy increased the relative risks of tumors, particularly SHNCs (RR = 1.78). The 10‐year OS rates of SHNCs after radiotherapy were significantly lower.ConclusionRadiotherapy improves survival in advanced‐stage MSGCs but increases the risk of developing SPMs, particularly SHNCs.

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“…12 Most recently, the American Radium Society published Appropriate Use Criteria for head and neck cancer re-irradiation which notes that SBRT has an important role for carefully selected patients. 13 Applying this safety and efficacy experience of SBRT re-irradiation to recurrent RMS-a much more radiosensitive disease often found in younger, healthier patients (compared to recurrent SCC of the head and neck)-is therefore quite compelling.…”

mentioning

confidence: 99%

Salvage stereotactic body radiation therapy re‐irradiation for unresectable locally recurrent nasopharyngeal rhabdomyosarcoma in a young adult: A case report

Buchberger

Cook

Anderson

et al. 2023

Pediatric Blood & Cancer

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Retreatment of Recurrent or Second Primary Head and Neck Cancer After Prior Radiation: Executive Summary of the American Radium Society Appropriate Use Criteria

Cited by 37 publications

References 271 publications

Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

Effectiveness and risk of second primary malignancies after radiotherapy in major salivary gland carcinomas: A retrospective study using SEER database

Salvage stereotactic body radiation therapy re‐irradiation for unresectable locally recurrent nasopharyngeal rhabdomyosarcoma in a young adult: A case report

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