A phase II study of primary reirradiation in squamous cell carcinoma of head and neck

JA Langendijk*, N Kasperts, CR Leemans, P Doornaert, BJ Slotman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

74 Citations (Scopus)

Abstract

Background and purpose: In this prospective study, the effect of a second course of primary radiotherapy on locoregional control, survival and toxicity was investigated, in patients who underwent a second course of high dose irradiation for second primary or locoregional recurrent squamous cell head and neck carcinoma (HNSCC) in a previously irradiated area.

Patients and methods: A total of 34 patients with second primary (n=26) or locoregional recurrent (n=8) tumours were treated with a second course of high dose radiotherapy. Patients were selected for re-irradiation in case of inoperable and/or unresectable tumours. In most cases, the target volume for re-irradiation was confined to the gross tumour volume (GTV). No elective radiotherapy was applied in the former high-dose area. A total dose of 46 Gy was applied to elective areas with a boost up to 60 Gy with conventional fractionation. The median follow-up period was 32 months.

Results: The locoregional control rate after 2 years was 27%. The 3-year overall survival was 22%. The most frequently reported acute side-effect was acute mucositis resulting in swallowing complaints. Pharyngeal and oesophageal late morbidity was also the most important late side-effect. In general, acute and late radiation-induced morbidity remained within acceptable limits.

Conclusions: In conclusion, primary re-irradiation appears to be feasible in terms of acute and late radiation-induced toxicity. To improve outcome in terms locoregional control and survival, future studies should be focussed on optimising radiation schedules and the addition of concomitant chemotherapy. (c) 2006 Elsevier Ireland Ltd.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalRadiotherapy and Oncology
Volume78
Issue number3
DOIs
Publication statusPublished - Mar-2006

Keywords

  • head and neck cancer
  • reirradiation
  • recurrence
  • second primary
  • POOR-PROGNOSIS HEAD
  • RECURRENT HEAD
  • ACCELERATED FRACTIONATION
  • CONCOMITANT CHEMOTHERAPY
  • DOSE REIRRADIATION
  • RADIATION-THERAPY
  • CANCER
  • RADIOTHERAPY
  • HYDROXYUREA
  • 5-FLUOROURACIL

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