Kakria Anjali, Rawat Sheh, Bhutani Ritu, Gupta Gourav, Devnani Bharti, Wahi Inderjeet K, Ahlawat Parveen
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Asia Pac J Clin Oncol. 2015 Jun;11(2):129-34. doi: 10.1111/ajco.12261. Epub 2014 Aug 17.
To present a retrospective analysis of treatment outcomes following reirradiation in locoregionally recurrent head and neck cancer patients at our institute.
Thirty-one patients of head and neck cancer who presented with a locoregional recurrence from April 2007 to April 2012 underwent salvage reirradiation. Median dose of first-time radiation was 70 Gy. Median duration of gap between the first and second course of radiation was 45.6 months. The median dose of reirradiation was 60 Gy. Conformal radiotherapy technique in the form of intensity modulated radiotherapy was used in 60% (17) of patients. Fourteen patients received concurrent chemotherapy or immunotherapy.
After a median follow-up of 20.6 months, 12 patients were alive with no evidence of disease. The 3-year disease-free survival and overall survival were 28.7 and 48.5%, respectively. Acute and late toxicities were reported in 29 and 61% of patients, respectively. Severe grade 3 and 4 late complications were observed in nine patients but none of them led to mortality.
Reirradiation appears to be both feasible and well tolerated in patients treated with previous radiotherapy for recurrent and second primary head and neck cancer. Careful case selection for reirradiation based on patient's performance status and tumor characteristics is essential.
对我院局部区域复发性头颈癌患者再次放疗后的治疗结果进行回顾性分析。
2007年4月至2012年4月期间,31例出现局部区域复发的头颈癌患者接受了挽救性再次放疗。首次放疗的中位剂量为70 Gy。首次与第二次放疗之间的间隔时间中位数为45.6个月。再次放疗的中位剂量为60 Gy。60%(17例)患者采用调强放疗形式的适形放疗技术。14例患者接受了同步化疗或免疫治疗。
中位随访20.6个月后,12例患者存活且无疾病证据。3年无病生存率和总生存率分别为28.7%和48.5%。分别有29%和61%的患者报告了急性和晚期毒性反应。9例患者观察到严重的3级和4级晚期并发症,但均未导致死亡。
对于接受过先前放疗的复发性和第二原发性头颈癌患者,再次放疗似乎既可行且耐受性良好。根据患者的体能状态和肿瘤特征仔细选择再次放疗的病例至关重要。