Toxicity and survival outcomes of hyperfractionated split‐course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers

Watkins, John M.; Shirai, Keisuke; Wahlquist, Amy E.; Stuart, Robert K.; Chaudhary, Uzair B.; Garrett‐Mayer, Elizabeth; Day, Terry A.; Gillespie, M. Boyd; Sharma, Anand K.

doi:10.1002/hed.20986

Cited by 32 publications

(21 citation statements)

References 21 publications

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“…The 2‐year OS rate was 26% and the 2‐year rate of grade ≥4 toxicity was around 30%. This is not clearly better than the results from the current study or other retrospective analyses 29, 30. In the postoperative reirradiation setting, Janot et al31 reported on 130 patients who underwent macroscopic radical salvage surgery, and were randomly assigned to either receive reirradiation combined with concomitant chemotherapy versus no adjuvant treatment.…”

Section: Discussioncontrasting

confidence: 61%

Reirradiation of head and neck cancer: Long‐term disease control and toxicity

et al. 2017

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BackgroundThe purpose of this study was to report long‐term disease control and late radiation toxicity for patients reirradiated for head and neck cancer.MethodsWe conducted a retrospective analysis of 137 patients reirradiated with a prescribed dose ≥45 Gy between 1986 and 2013 for a recurrent or second primary malignancy. Endpoints were locoregional control, overall survival (OS), and grade ≥4 late complications according to European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) criteria.ResultsFive‐year locoregional control rates were 46% for patients reirradiated postoperatively versus 20% for patients who underwent reirradiation as the primary treatment (p < .05). Sixteen cases of serious (grade ≥4) late toxicity were seen in 11 patients (actuarial 28% at 5 years). In patients reirradiated with intensity‐modulated radiotherapy (IMRT), a borderline improved locoregional control was observed (49% vs 36%; p = .07), whereas late complication rates did not differ.ConclusionReirradiation should be considered for patients with a recurrent or second primary head and neck cancer, especially postoperatively, if indicated. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1122–1130, 2017

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Section: Discussioncontrasting

confidence: 61%

Reirradiation of head and neck cancer: Long‐term disease control and toxicity

et al. 2017

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“…As trials showing a clear dose-response relationship became more common, with doses > 58 Gy improving survival [17,21], we changed our institutional practice to aim at a cumulative dose of 59.4 Gy for most patients. However, as this change was only established in the second half of 2011, the median dose for the patients in this analysis remains lower.…”

Section: Background and Purposementioning

confidence: 99%

Re-irradiation with cetuximab or cisplatin-based chemotherapy for recurrent squamous cell carcinoma of the head and neck

et al. 2015

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“…In patients with recurrent rectal carcinoma, high doses of hyperfractionated radiation may be delivered with acceptable risk, without prohibitive long-term side effects (18). Hyperfractionated re-irradiation has also been used to successfully manage locally recurrent lung cancer (19) and head and neck cancers (20). Moreover, hyperfractionated radiotherapy resulted in favorable outcomes for Japanese patients with head and neck carcinoma (21,22).…”

Section: Discussionmentioning

confidence: 99%

Re-irradiation of locoregional esophageal cancer recurrence following definitive chemoradiotherapy: A report of 6 cases

Katano

Yamashita

Nakagawa

2017

Molecular and Clinical Oncology

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Abstract. There is currently no consensus on salvage therapy for recurrent esophageal cancer. Salvage surgery is a well-established option for attaining long-term survival; however, it is associated with a high risk of perioperative morbidity and mortality. A total of 6 patients who underwent re-irradiation for recurrence of locoregional esophageal cancer following definitive chemoradiotherapy were investigated. The median interval between initial radiotherapy and re-irradiation was 17.4 months (range, 6.4-59.2 months). Re-irradiation salvage therapy was mostly administered with concurrent chemotherapy, which consisted of several cycles of nedaplatin on day 1 and oral S-1 administration on days 1-14. The median survival after re-irradiation was 13.6 months (range, 1.9-33.3 months). A total of 3 patients who completed hyperfractionated radiation therapy survived for >1 year. One patient has had no signs of recurrence or late radiation toxicity for >2 years. Severe acute hematological adverse events (AEs) occurred in 3 patients, including 1 case of grade 4 leukopenia. One severe late AE occurred in 1 patient, who developed grade 3 dysphagia and became permanently dependent on percutaneous endoscopic gastrostomy tube feeding. Salvage radiotherapy is considered to be a good treatment option for inoperable locoregional recurrent esophageal cancer. The results of the present study demonstrated that re-irradiation, with or without chemotherapy, for recurrent esophageal carcinoma after definitive chemoradiotherapy was tolerable and yielded reasonably satisfactory results.

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Toxicity and survival outcomes of hyperfractionated split‐course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers

Abstract: : Reirradiation can offer long-term survival for patients with recurrent, previously irradiated head/neck cancers.

Cited by 32 publications

References 21 publications

Reirradiation of head and neck cancer: Long‐term disease control and toxicity

Reirradiation of head and neck cancer: Long‐term disease control and toxicity

Re-irradiation with cetuximab or cisplatin-based chemotherapy for recurrent squamous cell carcinoma of the head and neck

Re-irradiation of locoregional esophageal cancer recurrence following definitive chemoradiotherapy: A report of 6 cases

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