title: Toxicity and survival outcomes of hyperfractionated split-course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA. watkinsm@musc.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Watkins
authors.forename: Keisuke S
authors.initials: KS
authors.lastname: Shirai
authors.forename: Amy E
authors.initials: AE
authors.lastname: Wahlquist
authors.forename: Robert K
authors.initials: RK
authors.lastname: Stuart
authors.forename: Uzair B
authors.initials: UB
authors.lastname: Chaudhary
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Garrett-Mayer
authors.forename: Terry A
authors.initials: TA
authors.lastname: Day
authors.forename: M Boyd
authors.initials: MB
authors.lastname: Gillespie
authors.forename: Anand K
authors.initials: AK
authors.lastname: Sharma
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents