Dose-escalated re-irradiation improves outcome in locally recurrent head and neck cancer – Results of a large multicenter analysis

Roesch, Johannes; Oertel, Michael; Wegen, Simone; Trommer, Maike; Schleifenbaum, Julia; Hering, Dominik; Mäurer, Matthias; Knippen, Stefan; Dobiasch, Sophie; Waltenberger, Maria; Grün, Jens von der; Medenwald, Daniel; Süß, Christoph; Hoeck, Michael; Käsmann, Lukas; Fleischmann, Daniel; Rühle, Alexander; Nicolay, Nils H.; Fabian, Alexander; Löser, Anastassia; Heß, Sebastian; Tamaskovics, Bálint; Vinsensia, Maria; Hecht, Markus

doi:10.1016/j.radonc.2022.10.007

Cited by 12 publications

(11 citation statements)

References 43 publications

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“…The selection of patients to undergo reirradiation is challenging and needs to be led by a multidisciplinary team. Patients with more than 2 years since their first course of radiation ( 34 ) and ECOG performance score of 0 ( 50 ) had better outcomes in this sample.…”

Section: Radiotherapy In Recurrent/metastatic Head and Neck Cancermentioning

confidence: 87%

Multimodality treatment in recurrent/metastatic squamous cell carcinoma of head and neck: current therapy, challenges, and future perspectives

Pannunzio,

Di Bello,

Occhipinti

et al. 2024

Front. Oncol.

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Squamous cell carcinoma of the head and neck is a complex group of diseases that presents a challenge to the clinician. The prognosis in the recurrent/metastatic disease is particularly dismal, with a median survival of approximately 12 months. Recently, the personalized and multimodal approach has increased prognosis by integrating locoregional strategies (salvage surgery and stereotactic radiotherapy) and systemic treatments (chemotherapy, immunotherapy, and target therapy). Malnutrition is a significant clinical problem that interferes with dose intensity, and thus, feeding supplementation is critical not only to increase the quality of life but also to improve overall survival. With this review, we want to emphasize the importance of the multidisciplinary approach, quality of life, and nutritional supportive care and to integrate the latest updates of predictive biomarkers for immunotherapy and future therapeutic strategies.

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Section: Radiotherapy In Recurrent/metastatic Head and Neck Cancermentioning

confidence: 87%

Multimodality treatment in recurrent/metastatic squamous cell carcinoma of head and neck: current therapy, challenges, and future perspectives

Pannunzio,

Di Bello,

Occhipinti

et al. 2024

Front. Oncol.

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“…On the other hand, the median survival of 23 months in patients with curative treatment intent, is a confirmation of the poor prognosis of these patients described in the literature [3] . The large differences reported in median survival of re-irradiated patients, from six to 28 months [28] , [29] , [30] , [31] , may be explained by the patient heterogeneity. Postoperative re-irradiation has been associated with improved survival versus primary re-irradiation [3] , [8] .…”

Section: Discussionmentioning

confidence: 98%

Impact of hyperfractionated re-irradiation on quality of life in patients with recurrent or second primary head and neck cancer, a prospective single institutional study

Amdal

Moan

Dale

et al. 2023

Clinical and Translational Radiation Oncology

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“…His study included 253 patients treated at 16 university hospitals. The results showed that patients with good ECOG PS and rRT doses above 50 Gy (EQD2) had median longer OS (17.8 months vs. 11.7 months, p < 0.01) and PFS (9.6 months vs. 6.8 months, p < 0.01) compared to those with poor ECOG PS and rRT below 50 Gy (EQD2) (p < 0.01) [22]. These findings provide important information for clinicians who are considering rRT treatment options for patients with rHNC [9,13,14].…”

Section: Discussionmentioning

confidence: 99%

Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

Mohamad

Hejleh

Abdelqader

et al. 2023

JCM

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Salvage re-irradiation (rRT) for patients with locoregionally recurrent head and neck cancer (rHNC) remains challenging. A retrospective analysis was performed on 49 patients who received rRT between 2011 and 2018. The co-primary endpoint of the study was 2-year freedom from cancer recurrence rate (FCRR) and overall survival (OS), and secondary endpoints were 2-year disease-free survival (DFS), local failure (LF), regional failure (RF), distant metastases (DM), and RTOG grade 3 ≥ late toxicities. Adjuvant and definitive rRT were delivered to 22 and 27 patients, respectively. A total of 91% of patients were managed with conventional re-RT and 71% of patients received concurrent chemotherapy. The median follow-up after rRT was 30 months. The 2-year FCRR, OS, DFS, LF, RF, and DM were 64%, 51%, 28%, 32%, 9%, and 39% respectively. MVA showed that poor performance status (PS: 1–2 vs. 0) and age > 52 years were predictive of worse OS. In comparison, poor PS (1–2 vs. 0) and total dose of rRT < 60 Gy were predictive of worse DFS. Late RTOG toxicity of grade 3 ≥ was reported in nine (18.3%) patients. FCRR at 2 years after salvage rRT for rHNC was higher than other traditional endpoints and could be an important endpoint to be included in future rRT studies. rRT for rHNC at our cohort was relatively successful, with a manageable level of late severe toxicity. Replacing this approach in other developing countries is a viable option.

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Dose-escalated re-irradiation improves outcome in locally recurrent head and neck cancer – Results of a large multicenter analysis

Cited by 12 publications

References 43 publications

Multimodality treatment in recurrent/metastatic squamous cell carcinoma of head and neck: current therapy, challenges, and future perspectives

Multimodality treatment in recurrent/metastatic squamous cell carcinoma of head and neck: current therapy, challenges, and future perspectives

Impact of hyperfractionated re-irradiation on quality of life in patients with recurrent or second primary head and neck cancer, a prospective single institutional study

Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

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