title: Re-irradiation with scanned charged particle beams in recurrent tumours of the head and neck: acute toxicity and feasibility.
abstract: BACKGROUND
  Treatment of surgically unresectable recurrence in the head and neck region remains a therapeutic problem with the only curative option being a second course of radiation with a tumouricidal dose. We report initial toxicity and efficacy of charged particle therapy in this situation.
  
  
  METHODS
  Treatment-related side-effects of patients treated with charged particle beams for recurrent tumours of the head and neck were prospectively collected and patient data was retrospectively analysed with regard to toxicity and efficacy of the treatment according to CTCAE v. 4.03 and RECIST.
  
  
  RESULTS
  Treatment was tolerated well without any severe acute toxicity. In non-chordoma/chondrosarcoma patients, overall response rate was 53.3% at 8 weeks post RT. 4/5 chordoma/chondrosarcoma patients showed no signs of further tumour progression.
  
  
  CONCLUSIONS
  Initial experience of re-irradiation with scanned particle beams in recurrent tumours of the head and neck seems feasible and encouraging. Further follow-up is needed to investigate potential late effects.
authors.affiliation: Department of Radiation Oncology, Heidelberg, Germany. alexandra.jensen@med.uni-heidelberg.de
authors.forename: Alexandra D
authors.initials: AD
authors.lastname: Jensen
authors.forename: Anna
authors.initials: A
authors.lastname: Nikoghosyan
authors.forename: Malte
authors.initials: M
authors.lastname: Ellerbrock
authors.forename: Swantje
authors.initials: S
authors.lastname: Ecker
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Marc W
authors.initials: MW
authors.lastname: Münter
mesh_terms: D000328:Adult; D000368:Aged; D002244:Carbon / Q000009:adverse effects / Q000627:therapeutic use*; D002813:Chondrosarcoma / Q000532:radiotherapy; D002817:Chordoma / Q000532:radiotherapy; D005240:Feasibility Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D061766:Proton Therapy; D011522:Protons / Q000009:adverse effects; D011880:Radiotherapy Planning, Computer-Assisted
chemical_list: D011522:Protons; D002244:Carbon