title: Reirradiation for patients with recurrence head and neck squamous cell carcinoma: a single-institution comparative study.
abstract: OBJECTIVE
  In the last decade, the number of publications that report on the use of external beam radiotherapy and high-dose-rate brachytherapy (HDR-BRT) in the treatment of recurrent head and neck cancer has increased, but no studies compare external beam radiotherapy and HDR-BRT. The aim of this study was to evaluate and to compare the efficacy and toxicity of the three-dimensional conformal radiotherapy (3D-CRT) and HDR-BRT in the treatment of recurrent head and neck cancer.
  
  
  METHODS
  A total of 64 patients with head and neck cancer recurrence were randomly assigned at a 1:1 ratio to receive either 3D-CRT (50Gy/25 fractions) in the control group or HDR-BRT (30Gy/12 fraction) in the experimental group.
  
  
  RESULTS
  The overall survival rate of patients treated with HDR-BRT at 1 and 2-years was 74% and 67%, respectively, compare to 3D-CRT group - 51% and 32%, respectively (P=0.002). Local control at 1- and 2-years in patients who received HDR-BRT was 77% and 63% compare with 47% and 25%, respectively, for the patients who received the 3D-CRT (P<0.001). Most patients developed mild to moderate acute mucositis and dermatitis. In the 3D-CRT group, severe late toxicity was determined in 11 patients (35.5%), and in the HDR-BRT group, in 1 patient (3.1%) (P=0.001). There was no grade 5 toxicity.
  
  
  CONCLUSIONS
  Following our results, we concluded that HDR-BRT is a more effective and safer treatment approach for head and neck cancer recurrences than 3D-CRT.
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: wictoras@hotmail.com.
authors.forename: Viktoras
authors.initials: V
authors.lastname: Rudžianskas
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Artūras
authors.initials: A
authors.lastname: Inčiūra
authors.affiliation: Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Saulius
authors.initials: S
authors.lastname: Vaitkus
authors.affiliation: Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Evaldas
authors.initials: E
authors.lastname: Padervinskis
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Milda
authors.initials: M
authors.lastname: Rudžianskienė
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Rita
authors.initials: R
authors.lastname: Kupčinskaitė-Noreikienė
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Lina
authors.initials: L
authors.lastname: Saltonaitė
authors.affiliation: Department of Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania.
authors.forename: Alius
authors.initials: A
authors.lastname: Noreika
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Akvilė
authors.initials: A
authors.lastname: Statnickaitė
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Elona
authors.initials: E
authors.lastname: Juozaitytė
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011855:Radiodermatitis / Q000209:etiology; D000069475:Re-Irradiation; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: Brachytherapy; Head and neck cancer; Reirradiation