Toxicity and survival outcomes of hyperfractionated split-course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers.
BACKGROUND
: Reirradiation of locoregionally recurrent, previously irradiated head/neck cancer may be considered in situations of unresectability, medical inoperability, or adverse pathologic features found at salvage resection.


METHODS
: Retrospective cohort analysis of toxicity and survival outcomes in locoregionally recurrent, previously irradiated patients with head/neck cancer treated with hyperfractionated split-course radiotherapy and concurrent chemotherapy.


RESULTS
: Between March 1998 and September 2006, 39 patients initiated reirradiation at median of 2.3 years (range, 0.5-19) following prior radiotherapy. At median survivor follow-up of 24.5 months (range, 3-63.9), 10 patients are alive without evidence of disease. Median survival is 19.0 months, with estimated 1-, 2-, and 3-year overall survivals of 60.1%, 45.1%, and 22.7%, respectively. Locoregional failure was the predominant site of postreirradiation recurrence. Male sex, total radiotherapy dose, cycles of chemotherapy completed, and clinical response were associated with improved overall survival.


CONCLUSIONS
: Reirradiation can offer long-term survival for patients with recurrent, previously irradiated head/neck cancers.
Watkins
John M
JM
Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA. watkinsm@musc.edu
Shirai
Keisuke S
KS
Wahlquist
Amy E
AE
Stuart
Robert K
RK
Chaudhary
Uzair B
UB
Garrett-Mayer
Elizabeth
E
Day
Terry A
TA
Gillespie
M Boyd
MB
Sharma
Anand K
AK
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology*; D019233:Retreatment; D015996:Survival Rate
D000970:Antineoplastic Agents