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Radiother Oncol. 2009 Dec;93(3):563-9. doi: 10.1016/j.radonc.2009.10.012. Epub 2009 Nov 16.

Intensity-modulated radiotherapy for recurrent and second primary head and neck cancer in previously irradiated territory.

Author information

1
Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium. frederic.duprez@ugent.be

Abstract

PURPOSE:

To evaluate re-irradiation using IMRT for recurrent and second primary head and neck cancer in previously irradiated territory.

MATERIALS AND METHODS:

Between 1997 and 2008, 84 patients with recurrent and second primary head and neck cancer were treated with IMRT to a median dose of 69 Gy. Median time interval between initial radiotherapy and re-irradiation was 49.5 (5.2-298.3) months. Salvage surgery preceded re-irradiation in 19 patients; 17 patients received concurrent chemotherapy.

RESULTS:

Median follow-up of living patients was 19.8 (1.9-76.1) months. Five-year locoregional control and overall survival were 40% and 20%, respectively. Five-year disease-specific survival and disease-free survival were 29% and 15%, respectively. Stage T4 (p=0.015), time interval between initial treatment and re-irradiation (p=0.011) and hypopharyngeal cancer (p=0.013) were independent prognostic factors for worse overall survival in multivariate analysis. Twenty-six and 11 patients developed Grade 3 acute and late toxicity, respectively. No Grade 5 acute toxicity was encountered. There were 2 fatal vascular ruptures during follow-up.

CONCLUSIONS:

High-dose IMRT for recurrent and second primary head and neck cancer in previously irradiated territory leads to approximately 20% long-term survival in a non-selected patient population. Identification of patients who would benefit most of curative IMRT is warranted.

PMID:
19919885
DOI:
10.1016/j.radonc.2009.10.012
[Indexed for MEDLINE]
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