IMRT Reirradiation of Head and Neck Cancer-Disease Control and Morbidity Outcomes

Journal Article · Sun Feb 01 04:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.04.021· OSTI ID:21172581

Sulman, Erik P ^[1]; Schwartz, David L ^[1]; Le, Thuy T; Ang, K Kian; Morrison, William H; Rosenthal, David I; Ahamad, Anesa ^[1]; Kies, Merril; Glisson, Bonnie ^[2]; Weber, Randal ^[3]; Garden, Adam S ^[1]

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1. Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
2. Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
3. Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

Purpose: Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients. Methods and Materials: Records of 78 consecutive patients reirradiated with IMRT for head and neck cancer between 1999 and 2004 were reviewed; 74 cases were analyzed. Reirradiation was defined as any overlap between original and new radiation treatment volumes regardless of the time interval between initial and subsequent treatment. Severe reirradiation-related toxicity was defined as toxic events resulting in hospitalization, corrective surgery, or patient death. Longitudinal estimates of survival were calculated by Kaplan-Meier technique. Results: Twenty (27%) patients underwent salvage surgical resection and 36 (49%) patients received chemotherapy. Median follow-up from reirradiation was 25 months. Median time interval between initial radiation and reirradiation was 46 months. Median reirradiation dose was 60 Gy. Median lifetime radiation dose was 116.1 Gy. The 2-year overall survival and locoregional control rates were 58% and 64%, respectively. Severe reirradiation related toxicity occurred in 15 patients (20%); one treatment-related death was observed. Conclusions: The use of IMRT for reirradiation of recurrent or second primary head and neck cancers resulted in encouraging local control and survival. Reirradiation-related morbidity was significant, but may be less severe than previously published reports using conventional techniques.

• OSTI ID: 21172581
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 73; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
DEATH
DISEASE INCIDENCE
HEAD
IRRADIATION
NECK
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SURGERY
TOXICITY