Outcomes of patients with loco-regionally recurrent or new primary squamous cell carcinomas of the head and neck treated with curative intent reirradiation at Mayo Clinic

Autor: Ashley L. Garrett, Ajay B. Patel, Michele Y. Halyard, Samir H. Patel, Theresa Ann Jizba, Kelly K. Curtis, Helen J. Ross, William W. Wong, Stephen J. Ko, Heidi E. Kosiorek, Robert L. Foote
Rok vydání: 2015
Předmět:
Oncology
Re-Irradiation
Male
medicine.medical_treatment
Salvage therapy
Kaplan-Meier Estimate
030218 nuclear medicine & medical imaging
0302 clinical medicine
Survival outcomes
Reirradiation
Aged
80 and over
Radiotherapy Dosage
Middle Aged
Combined Modality Therapy
Treatment Outcome
Radiology Nuclear Medicine and imaging
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Carcinoma
Squamous Cell
Female
Adult
medicine.medical_specialty
Osteoradionecrosis
Radiation Dosage
Disease-Free Survival
03 medical and health sciences
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Radiometry
Aged
Proportional Hazards Models
Retrospective Studies
Salvage Therapy
Chemotherapy
Radiotherapy
Toxicity
business.industry
Proportional hazards model
Squamous Cell Carcinoma of Head and Neck
Research
Retrospective cohort study
medicine.disease
Radiation therapy
Radiotherapy
Intensity-Modulated
Recurrent squamous cell carcinoma head and neck
Neoplasm Recurrence
Local
business
Zdroj: Radiation Oncology (London, England)
ISSN: 1748-717X
Popis: Background We reviewed outcomes of patients with loco-regionally recurrent (LRR) or new primary (NP) squamous cell carcinoma of the head and neck (SCCHN) treated at our institution with reirradiation (RRT). Methods Patients received definitive RRT (DRRT) or post-operative RRT following salvage surgery (PRRT) from 2003 to 2011. Measured survival outcomes included loco-regional relapse free survival (LRFS) and overall survival (OS). Results Among 81 patients (PRRT, 42; DRRT, 39), median PRRT and DRRT doses were 60 Gy (12–70 Gy) and 69.6 Gy (48–76.8 Gy). The majority of patients received IMRT-based RRT (n = 77, 95 %). With median follow-up of 78.1 months (95 % CI, 56–96.8 months), 2-year OS was 53 % with PRRT and 48 % with DRRT (p = 0.12); 23 % of patients were alive at last follow-up. LRFS at 2 years was 60 %, and did not differ significantly between PRRT and DRRT groups. A trend toward inferior LRFS was noted among patients receiving chemotherapy with RRT versus RRT alone (p = 0.06). Late serious toxicities were uncommon, including osteoradionecrosis (2 patients) and carotid artery bleeding (1 patient, non-fatal). Conclusions OS of PRRT- and DRRT-treated patients in this series appears superior to the published literature. We used IMRT for the majority of patients, in contrast to several series and trials previously reported, which may account in part for this difference. Future studies should seek to improve outcomes among patients with LRR/NP SCCHN via alternative therapeutic modalities such as proton radiotherapy and by incorporating novel systemic agents.
Databáze: OpenAIRE
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