title: Reirradiation of recurrent head and neck cancers: external and/or interstitial radiation therapy.
abstract: Recurrent cancer in the head and neck is not an uncommon clinical problem. The average cure rate of these patients has been reported to vary between 30 and 40% and most failures are due to locoregional relapses. After a previous full course of radiation, surgery is the salvage modality of choice; however, if surgery was not feasible for whatever reason, reirradiation has been offered to some patients. To establish the role of reirradiation in head and neck cancer, we analyzed a 13-year experience with patients reirradiated in the DDHCC. The reirradiation was performed between 1970 and 1980 by means of external beam radiation therapy (ERT series; n = 55) and between 1985 and 1988 by external radiation combined with interstitial radiation therapy (IRT +/- ERT series; n = 18). A minimum follow-up of 3 years was allowed for. An improvement in local control was observed (50% vs. 29%) for the IRT +/- ERT series and the ERT series, respectively. The improvement in local control was not reflected in a survival benefit; i.e. an actuarial overall survival of 20% at 5 years was observed in both series. No treatment-related deaths occurred. However, for the patients that were controlled at the reirradiated site, 28% (4/16 of the ERT series and 3/9 of the IRT +/- ERT series) did experience severe side effects.
authors.affiliation: Dr. Daniel den Hoed Cancer Center, Department of Radiation Oncology, Groene Hilledijk, Rotterdam, The Netherlands.
authors.forename: P C
authors.initials: PC
authors.lastname: Levendag
authors.forename: C A
authors.initials: CA
authors.lastname: Meeuwis
authors.forename: A G
authors.initials: AG
authors.lastname: Visser
mesh_terms: D001918:Brachytherapy; D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D011832:Radiation Injuries / Q000517:prevention & control; D011879:Radiotherapy Dosage