title: Reirradiation for recurrent head and neck cancer.
abstract: Recurrence of head and neck cancer in a previously irradiated volume presents a challenging problem and has poor prognosis. A minority of patients are eligible for the preferred therapy, surgical resection. Systemic therapy is offered to patients with unresectable disease but offers little, if any, chance of cure. Repeat irradiation with systemic therapy is a potentially curative option. One randomized trial and several cooperative group and institutional studies support its use. Long-term disease-free survival has been observed, albeit with the risk of significant, possibly life threatening, late complications. Intensity-modulated radiotherapy has been shown to reduce toxicity and improve disease control. Novel systemic therapies and radiotherapy techniques, including stereotactic body radiotherapy, are under active study.
authors.affiliation: Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27713, USA.
authors.forename: Pretesh R
authors.initials: PR
authors.lastname: Patel
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
mesh_terms: D016371:Cranial Irradiation / Q000009:adverse effects*; D004307:Dose-Response Relationship, Radiation; D055317:Evidence-Based Practice / Q000379:methods; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D010347:Patient Care Planning; D018579:Patient Selection; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D019233:Retreatment / Q000379:methods*; D018570:Risk Assessment; D016879:Salvage Therapy / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome