Re-irradiation for isolated neck recurrence in head and neck tumor: impact of rN category.

Autor: Yamazaki H; Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan. hideya10@hotmail.com.; CyberKnife Center, Soseikai General Hospital, Kyoto, Japan. hideya10@hotmail.com., Suzuki G; Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan., Aibe N; Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan., Shiomi H; CyberKnife Center, Soseikai General Hospital, Kyoto, Japan., Oh RJ; Department of Radiation Oncology, Miyakojima IGRT Clinic, Osaka, Japan., Yoshida K; Department of Radiology, Kansai Medical University, Hirakata, Japan., Nakamura S; Department of Radiology, Kansai Medical University, Hirakata, Japan., Konishi K; Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan., Matsuyama T; Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan., Ogita M; Radiotherapy Department, Fujimoto Hayasuzu Hospital, Miyakonojo, Japan.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Feb 07; Vol. 14 (1), pp. 3107. Date of Electronic Publication: 2024 Feb 07.
DOI: 10.1038/s41598-024-53438-w
Abstrakt: Unresectable, isolated lymph node recurrence after radiotherapy is rare but a candidate for re-irradiation. However, severe toxicity is anticipated. Therefore, this study aimed to explore the efficacy and toxicity of re-irradiation in isolated lymph node recurrence of head and neck lesions. We analyzed 46 patients who received re-irradiation for lymph node recurrence without local progression. The primary tumor sites included the oral cavity in 17 patients, the hypopharynx in 12, the oropharynx in seven, the larynx in three, the nasopharynx in two, and other sites. During a median follow-up time of 10 months, the median survival time was 10.6 months, and the 1-year overall survival rate was 45.5%. The 1-year local control and progression-free survival rates were 49.8% and 39.3%, respectively. According to univariate analysis, age (≥ 65 years), the interval between treatment (≥ 12 months), rN category (rN1), and gross tumor volume (GTV < 25 cm 3 ) were predisposing factors for better survival. In the multivariate analysis, the rN category and interval were identified as statistically significant predictors. Late toxicity grade ≥ 3 occurred in four patients (8.6%). These were all Grade 5 carotid blowout syndrome, which associated with tumor invasion of the carotid artery and/ or high doses administration for the carotid artery. Small-volume rN1 tumor that recur after a longer interval is a feasible candidate for re-irradiation. However, strict patient selection and meticulous care for the carotid are required.
(© 2024. The Author(s).)
Databáze: MEDLINE
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