An Overview of Head and Neck Tumor Reirradiation: What Has Been Achieved So Far?

Abstract

The recurrence rate of head and neck cancers (HNCs) after initial treatment may reach 70%, and poor prognosis is reported in most cases. Curative options for recurrent HNCs mainly depend on the treatment history and the recurrent tumor localization. Reirradiation for HNCs is effective and has been included in most guidelines. However, the option remains clinically challenging due to high incidence of severe toxicity, especially in cases of quick infield recurrence. Recent technical advances in radiation therapy (RT) provide the means for upgrade in reirradiation protocols. While the majority of hospitals stay focused on conventional and widely accessible modulated RTs, the particle therapy options emerge as tolerable and providing further treatment opportunities for recurrent HNCs. Still, the progress is impeded by high heterogeneity of the data and the lack of large-scale prospective studies. This review aimed to summarize the outcomes of reirradiation for HNCs in the clinical perspective.

Interventional radiotherapy (brachytherapy) for re-irradiation of recurrent head and neck malignancies: oncologic outcomes and morbidity

“…Head and neck cancer (HNC) is the sixth most common cancer globally, and despite recent oncologic advancements, nearly 50% of patients experience a recurrence within two years of initial treatment 1 . Management of recurrent HNC is challenging.…”

“…Management of recurrent HNC is challenging. Re-irradiation represents a potential treatment option in already irradiated cases: even if potentially associated to a certain degree of toxicity and limited data about its effectiveness are so far available, its indications are evolving thanks to emerging evidence and technological advancements 1 . In fact, in the last decades, brachytherapy (BT), has drastically changed and improved through dramatic technical developments, such as intensity dose modulation and image guidance, leading to a “new” proposed definition as “Interventional Radiotherapy” (IRT) in order to stress the differences with the older technique 2 .…”

Elucidating Hedgehog pathway's role in HNSCC progression: insights from a 6-gene signature

“…Open and minimally invasive surgery is standardized treatment for most patients with oral and early laryngeal cancers, whereas the rest HNSCC cases are treated by radiotherapy or concurrent chemoradiotherapy 6 , 7 . The recurrence rate of HNSCC after initial treatment can reach 70%, and the majority of cases are reported to have a poor prognosis 8 . Challenges remain in all aspects of HNSCC management.…”

Clinical Advances and Future Directions of Oncolytic Virotherapy for Head and Neck Cancer

“…Surgery is the primary treatment modality for HNSCC [3,[10][11][12], while radiotherapy and chemotherapy are the main treatment options for inoperable cases, advanced-stage disease, or recurrent cases [13][14][15][16]. Digital techniques, navigation surgery, and artificial intelligence have been integrated into the overall management of HNCs, further enhancing the precision, safety, and effectiveness of treatment plans [17][18][19].…”