Evidence based and new developments in re-irradiation for recurrent or second primary head and neck cancers
| Autor: | Eric Lartigau, Raphaëlle Mouttet-Audouard, Louis Gras, B. Comet |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Re-Irradiation
Oncology medicine.medical_specialty Evidence-based practice medicine.medical_treatment Population Radiosurgery Disease-Free Survival Targeted therapy Internal medicine Medicine Humans education Chemotherapy education.field_of_study business.industry Standard treatment Second primary cancer Chemoradiotherapy Radiation therapy Otorhinolaryngology Head and Neck Neoplasms Surgery Radiotherapy Intensity-Modulated Neoplasm Recurrence Local business |
| Zdroj: | Current opinion in otolaryngologyhead and neck surgery. 20(2) |
| ISSN: | 1531-6998 |
| Popis: | PURPOSE OF REVIEW The standard treatment for recurrent or second primary head and neck cancers is surgery which can only be performed in 25% of the patients. For inoperable patients, three options can be discussed: supportive care only, chemotherapy or radiotherapy with or without chemotherapy. The goal of this article is to review the indications and new developments in re-irradiation for recurrent or second primary head and neck cancers. RECENT FINDINGS The le Groupe d'Etude des Tumeurs de la Tete et du Cou (GETTEC)-le Groupe d'Oncologie et de Radiotherapie Tete et Cou (GORTEC) (99-01) trial showed that radio-chemotherapy improved disease-free survival for a highly selected population. All conventional and conformational radiotherapy series showed improved local control and disease-free survival rates, but at the expense of acute and late toxicities demanding a drastic patients selection. New radiotherapy techniques such as intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT) have improved oncological results with reduced toxicities, offering treatments which are spread over six to seven weeks for IMRT and two weeks for SBRT. SUMMARY Re-irradiation is an attractive alternative treatment for selected inoperable patients and its effectiveness can be potentiated by systemic treatments such as chemotherapy or targeted therapy. The development of new radiotherapy techniques such as IMRT and SBRT has improved healthy tissues tolerance and future studies should help define the specific IMRT and SBRT indications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|