Reirradiation in head and neck cancer patients after recurrence or new primary tumors
Reports of Practical Oncology & Radiotherapy
reports of practical oncology and radiotherapy 1 8 ( 2 0 1 3 ) S237-S258 S251 has no impact on local control when bone involvement or resection margins were positive, but if the resection was complete, most authors recommend the use of these two treatment arms. http://dx. Objective. To analyze the acute toxicities in rRT with curative intent in CCC. Methods. Retrospective review of 21 patients reirradiated due to CCC with curative intent between May 2004 and December 2012. All were treated by
... technique with 6 MV photons. On 1st fractionation RT with 2 Gy/day and rRT with 1.8 Gy/day. Toxicity was collected according to RTOG scale. Results. Initial treatment was concomitant cisplatin-based chemoradiation in 9 patients, surgery plus adjuvant RT in 7, neoadjuvant RTCT in 3 and exclusive RT in 2. In the second disease were 11 local recurrences objectified, 7 nodal recurrences and 3 seconds tumors. We chose concomitant RTCT with different chemotherapy regimens in 11 patients, surgery plus adjuvant RTCT in 7 patients and surgery plus adjuvant RT in 3. The average time between the end of the first irradiation and rRT was 24 months, one case less than six months. The mean dose of the 1st RT was 67.7 Gy and 64.3 Gy in rRT. The PTV in the 1st irradiation was 256.8 cc and 119.3 cc of the rRT. The acute toxicities occur in higher incidence in the rRT. Radiodermatitis was presented in 25% in the 1 st RT (grade I 25%, 50% Grade II, 25% Grade III) and 50% by rRT (grade II 37%, 63% Grade III). Odynophagia occurred in 31.3% in the 1st RT (grade I 20%, 60% grade II, grade III 20%) and 43.8% in rRT (grade II 57.1%, 42.9% grade III). Mucositis was presented in 37.5% in the 1st RT (grade I 33%, 33% grade II, grade III 33%) and 25% by rRT (grade I 25%, 50% grade II, 25 grade III %). Note that it has made no toxic death by rRT. To date, the average follow-up is 15.4 months. Currently 7 patients are alive, free of disease 4. Conclusions. We believe that the rRT in CCC is acceptably tolerated and should be considered as a therapeutic option in selected cases. http://dx.