Re-irradiation of head and neck cancer-impact of total dose on outcome

Anticancer Res. 2010 Sep;30(9):3781-6.

Abstract

Aim: To evaluate the outcome of re-irradiation and to define favourable pre-treatment characteristics.

Patients and methods: seventy-five patients with locally recurrent head and neck cancer were treated with re-irradiation, either postoperatively or as definitive treatment, with and without chemotherapy. Mean time period between first and second series of irradiation was 19 months. Mean overall dose of re-irradiation was 46 Gy. Median follow-up was 8.7 months.

Results: Overall survival, loco-regional disease-free survival and metastasis-free survival after two years were 23%, 24% and 77%, respectively. Higher overall doses of re-irradiation gave a statistically significant better outcome with regard to overall survival (p=0.018).

Conclusion: For patients with locally recurrent head and neck cancer, re-irradiation is a feasible therapeutic option. The total dose at re-irradiation improves overall survival. Therefore, re-irradiation with curative intent should only be applied if a sufficient total dose of ≥46 Gy can be given.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / radiotherapy*
  • Radiation Dosage
  • Treatment Failure