Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Semin Radiat Oncol. 2012 Jul;22(3):214-9. doi: 10.1016/j.semradonc.2012.03.006.
During the past 2 decades, concurrent chemotherapy with reirradiation (reRT) has matured from a fear-provoking, rarely performed therapeutic strategy to an accepted mainstream option for selected patients with recurrent or second primary squamous cell head and neck cancer in previously irradiated fields. Attempts by investigators to advance and improve reRT have included multiple new approaches, such as the use of reRT in the postoperative setting, the integration of new radiation techniques, as well as the addition of targeted agents into reRT regimens. We review and discuss recent studies that address these areas. Although clinical research efforts to examine new reRT regimens are valuable, we have reached a plateau in the acquisition of significant new knowledge because of a paucity of prospective multicenter studies and a near total absence of randomized phase III trials. Analysis of recent reRT studies points out areas where incremental advances have been made, but more importantly, we provide a guide to the priorities on which future investigations should focus.
在过去的 20 年中，同期放化疗（reRT）已从一种令人恐惧、很少采用的治疗策略发展成为在先前照射野内复发或出现第二原发的鳞状细胞头颈部癌的特定患者的一种可接受的主流选择。研究人员尝试通过多种新方法来推进和改进 reRT，例如在术后环境中使用 reRT、整合新的放射技术以及在 reRT 方案中添加靶向药物。我们回顾并讨论了最近涉及这些领域的研究。虽然检查新的 reRT 方案的临床研究工作很有价值，但由于前瞻性多中心研究的缺乏和几乎完全没有随机 III 期试验，我们在获取新的重要知识方面已经达到了一个瓶颈。对最近的 reRT 研究的分析指出了取得渐进式进展的领域，但更重要的是，我们为未来研究应关注的重点提供了指导。
