title: Reirradiation for second primary or recurrent cancers of the head and neck: Dosimetric and outcome analysis.
abstract: The purpose of this study was to examine outcomes, toxicity, and dosimetric characteristics of patients treated with reirradiation for head and neck cancers.
  
  
  
  Fifty patients underwent ≥2 courses of radiation therapy (RT) postoperatively or definitively with or without chemotherapy. Composite dose volume histograms (DVHs) for selected anatomic structures were correlated with grade ≥3 late toxicity.
  
  
  
  Median initial and retreatment radiation dose was 64 and 60 Gy, respectively. Median overall survival (OS), progression-free survival (PFS), and 1-year PFS rates were 18 months, 11 months, and 45%, respectively, with 13 months median follow-up. Thirty-four percent of patients experienced grade ≥3 late toxicity with 1 death from carotid blowout. The DVH corresponding to the carotid blowout fell above the third quartile compared with other patients.
  
  
  
  Our analysis is the first to systematically evaluate the dose to the carotid artery using composite dosimetry in head and neck reirradiation patients, and demonstrates a promising technique for evaluating the dose to other normal tissue structures. © 2015 Wiley Periodicals, Inc. Head Neck 38: E961-E969, 2016.
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Shivank
authors.initials: S
authors.lastname: Garg
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Kilburn
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: John T
authors.initials: JT
authors.lastname: Lucas
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: David
authors.initials: D
authors.lastname: Randolph
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: James J
authors.initials: JJ
authors.lastname: Urbanic
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: William H
authors.initials: WH
authors.lastname: Hinson
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: William T
authors.initials: WT
authors.lastname: Kearns
authors.affiliation: Department of Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Porosnicu
authors.affiliation: Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Greven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D016609:Neoplasms, Second Primary / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D000069475:Re-Irradiation; D012189:Retrospective Studies
keywords: blowout; carotid arteries; dosimetry; head and neck; reirradiation