title: Retrospective analysis of treatment outcomes following reirradiation in locoregionally recurrent head and neck cancer patients: A single institutional study.
abstract: OBJECTIVE
  To present a retrospective analysis of treatment outcomes following reirradiation in locoregionally recurrent head and neck cancer patients at our institute.
  
  
  METHODS
  Thirty-one patients of head and neck cancer who presented with a locoregional recurrence from April 2007 to April 2012 underwent salvage reirradiation. Median dose of first-time radiation was 70 Gy. Median duration of gap between the first and second course of radiation was 45.6 months. The median dose of reirradiation was 60 Gy. Conformal radiotherapy technique in the form of intensity modulated radiotherapy was used in 60% (17) of patients. Fourteen patients received concurrent chemotherapy or immunotherapy.
  
  
  RESULTS
  After a median follow-up of 20.6 months, 12 patients were alive with no evidence of disease. The 3-year disease-free survival and overall survival were 28.7 and 48.5%, respectively. Acute and late toxicities were reported in 29 and 61% of patients, respectively. Severe grade 3 and 4 late complications were observed in nine patients but none of them led to mortality.
  
  
  CONCLUSIONS
  Reirradiation appears to be both feasible and well tolerated in patients treated with previous radiotherapy for recurrent and second primary head and neck cancer. Careful case selection for reirradiation based on patient's performance status and tumor characteristics is essential.
authors.affiliation: Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Kakria
authors.forename: Sheh
authors.initials: S
authors.lastname: Rawat
authors.forename: Ritu
authors.initials: R
authors.lastname: Bhutani
authors.forename: Gourav
authors.initials: G
authors.lastname: Gupta
authors.forename: Bharti
authors.initials: B
authors.lastname: Devnani
authors.forename: Inderjeet K
authors.initials: IK
authors.lastname: Wahi
authors.forename: Parveen
authors.initials: P
authors.lastname: Ahlawat
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D000069475:Re-Irradiation / Q000379:methods*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
keywords: conformal radiation; head and neck; recurrent; reirradiation; salvage therapy