Reirradiation of recurrent head and neck cancers with curative intent.
In patients with recurrent, previously irradiated head and neck cancer, the traditional therapy of palliative single- or multi-agent chemotherapy yields a 30% to 40% response rate with median survival durations of 8 to 10 months. However, long-term survival is rarely observed. Reirradiation with or without concurrent chemotherapy is currently under investigation as a treatment option in these patients. While reirradiation without chemotherapy appears to be effective in recurrent nasopharynx cancer cases, the use of concomitant chemotherapy with reirradiation appears to offer improved outcomes based on phase I/II data in other head and neck sites. Recent studies indicate that long-term survival of patients is possible following reirradiation in a minority of cases despite severe acute and chronic toxicities. Reirradiation with chemotherapy is appropriate for patients with a goal of long-term local control of disease and curative intent, despite the risk of significant acute and late toxicities.
Chmura
Steven J
SJ
Department of Radiation and Cellular Oncology, 5758 S. Maryland, MC 9006, Chicago, IL 60637, USA. schmura@radonc.uchicago.edu
Milano
Michael T
MT
Haraf
Daniel J
DJ
D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D010166:Palliative Care; D016879:Salvage Therapy