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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
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