Cargando…
Re-irradiation for recurrent or second primary head and neck cancer
PURPOSE: To investigate the efficacy and safety of intensity-modulated radiotherapy (IMRT)-based re-irradiation (reRT) for recurrent or second primary head and neck cancer (HNC). MATERIALS AND METHODS: Patients who underwent IMRT-based reRT for recurrent or second primary HNC between 2007 and 2019 a...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society for Radiation Oncology
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743457/ https://www.ncbi.nlm.nih.gov/pubmed/34986549 http://dx.doi.org/10.3857/roj.2021.00640 |
_version_ | 1784629909236219904 |
---|---|
author | Lee, Hye In Kim, Jin Ho Ahn, Soon-Hyun Chung, Eun-Jae Keam, Bhumsuk Eom, Keun-Yong Jeong, Woo-Jin Kim, Ji-Won Wee, Chan Woo Wu, Hong-Gyun |
author_facet | Lee, Hye In Kim, Jin Ho Ahn, Soon-Hyun Chung, Eun-Jae Keam, Bhumsuk Eom, Keun-Yong Jeong, Woo-Jin Kim, Ji-Won Wee, Chan Woo Wu, Hong-Gyun |
author_sort | Lee, Hye In |
collection | PubMed |
description | PURPOSE: To investigate the efficacy and safety of intensity-modulated radiotherapy (IMRT)-based re-irradiation (reRT) for recurrent or second primary head and neck cancer (HNC). MATERIALS AND METHODS: Patients who underwent IMRT-based reRT for recurrent or second primary HNC between 2007 and 2019 at two institutions were included. Medical records and dosimetric data were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), severe late toxicities, and clinicopathological prognostic factors were analyzed. RESULTS: A total of 42 patients were analyzed. With a median follow-up of 15.1 months (range, 3.7 to 85.8 months), the median OS was 28.9 months with a 2-year OS rate of 54.6%. The median PFS and 2-year PFS rates were 10.0 months and 30.9%, respectively. Multivariate analysis showed that good performance (Eastern Cooperative Oncology Group [ECOG] 0 or 1), a longer time interval (≥24 months) between radiotherapy courses, and higher reRT dose (>60 Gy) were significantly favorable factors for OS (all p < 0.05). Higher reRT dose and salvage surgery were significantly associated with improved PFS (all p < 0.05). Regarding the Multi‐Institution Reirradiation (MIRI) Collaborative RPA classification, the 2-year OS rates of each class were 87.5% in class I, 51.8% in class II, and 0% in class III (p = 0.008). Grade ≥3 late toxicity was reported in 10 (23.8%) patients. There was no significant factor associated with increased late toxicities. CONCLUSION: IMRT-based reRT should be considered as a treatment option for patients with recurrent or second primary HNC. Further trials are needed to establish a subset of patients who may benefit from reRT without severe late toxicity. |
format | Online Article Text |
id | pubmed-8743457 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Society for Radiation Oncology |
record_format | MEDLINE/PubMed |
spelling | pubmed-87434572022-01-14 Re-irradiation for recurrent or second primary head and neck cancer Lee, Hye In Kim, Jin Ho Ahn, Soon-Hyun Chung, Eun-Jae Keam, Bhumsuk Eom, Keun-Yong Jeong, Woo-Jin Kim, Ji-Won Wee, Chan Woo Wu, Hong-Gyun Radiat Oncol J Original Article PURPOSE: To investigate the efficacy and safety of intensity-modulated radiotherapy (IMRT)-based re-irradiation (reRT) for recurrent or second primary head and neck cancer (HNC). MATERIALS AND METHODS: Patients who underwent IMRT-based reRT for recurrent or second primary HNC between 2007 and 2019 at two institutions were included. Medical records and dosimetric data were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), severe late toxicities, and clinicopathological prognostic factors were analyzed. RESULTS: A total of 42 patients were analyzed. With a median follow-up of 15.1 months (range, 3.7 to 85.8 months), the median OS was 28.9 months with a 2-year OS rate of 54.6%. The median PFS and 2-year PFS rates were 10.0 months and 30.9%, respectively. Multivariate analysis showed that good performance (Eastern Cooperative Oncology Group [ECOG] 0 or 1), a longer time interval (≥24 months) between radiotherapy courses, and higher reRT dose (>60 Gy) were significantly favorable factors for OS (all p < 0.05). Higher reRT dose and salvage surgery were significantly associated with improved PFS (all p < 0.05). Regarding the Multi‐Institution Reirradiation (MIRI) Collaborative RPA classification, the 2-year OS rates of each class were 87.5% in class I, 51.8% in class II, and 0% in class III (p = 0.008). Grade ≥3 late toxicity was reported in 10 (23.8%) patients. There was no significant factor associated with increased late toxicities. CONCLUSION: IMRT-based reRT should be considered as a treatment option for patients with recurrent or second primary HNC. Further trials are needed to establish a subset of patients who may benefit from reRT without severe late toxicity. The Korean Society for Radiation Oncology 2021-12 2021-12-07 /pmc/articles/PMC8743457/ /pubmed/34986549 http://dx.doi.org/10.3857/roj.2021.00640 Text en Copyright © 2021 The Korean Society for Radiation Oncology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Hye In Kim, Jin Ho Ahn, Soon-Hyun Chung, Eun-Jae Keam, Bhumsuk Eom, Keun-Yong Jeong, Woo-Jin Kim, Ji-Won Wee, Chan Woo Wu, Hong-Gyun Re-irradiation for recurrent or second primary head and neck cancer |
title | Re-irradiation for recurrent or second primary head and neck cancer |
title_full | Re-irradiation for recurrent or second primary head and neck cancer |
title_fullStr | Re-irradiation for recurrent or second primary head and neck cancer |
title_full_unstemmed | Re-irradiation for recurrent or second primary head and neck cancer |
title_short | Re-irradiation for recurrent or second primary head and neck cancer |
title_sort | re-irradiation for recurrent or second primary head and neck cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743457/ https://www.ncbi.nlm.nih.gov/pubmed/34986549 http://dx.doi.org/10.3857/roj.2021.00640 |
work_keys_str_mv | AT leehyein reirradiationforrecurrentorsecondprimaryheadandneckcancer AT kimjinho reirradiationforrecurrentorsecondprimaryheadandneckcancer AT ahnsoonhyun reirradiationforrecurrentorsecondprimaryheadandneckcancer AT chungeunjae reirradiationforrecurrentorsecondprimaryheadandneckcancer AT keambhumsuk reirradiationforrecurrentorsecondprimaryheadandneckcancer AT eomkeunyong reirradiationforrecurrentorsecondprimaryheadandneckcancer AT jeongwoojin reirradiationforrecurrentorsecondprimaryheadandneckcancer AT kimjiwon reirradiationforrecurrentorsecondprimaryheadandneckcancer AT weechanwoo reirradiationforrecurrentorsecondprimaryheadandneckcancer AT wuhonggyun reirradiationforrecurrentorsecondprimaryheadandneckcancer |