Highly conformal reirradiation in patients with prior oropharyngeal radiation: Clinical efficacy and toxicity outcomes. Issue 11 (9th August 2020)

• Record Type: Journal Article
• Authors: Bagley, Alexander F.; Garden, Adam S.; Reddy, Jay P.; Moreno, Amy C.; Frank, Steven J.; Rosenthal, David I.; Morrison, William H.; Gunn, Gary Brandon; Fuller, Clifton D.; Shah, Shalin J.; Ferrarotto, Renata; Sturgis, Erich M.; Gross, Neil D.; Phan, Jack
• Is Part Of: Head & neck. Volume 42:Issue 11(2020)
• Page Start: 3326
• Page End: 3335
• Publication Date: 2020-08-09
• Subjects: highly conformal radiotherapy -- oropharyngeal carcinoma -- reirradiation; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26384
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Reirradiation of head and neck cancer is associated with high rates of locoregional failure and potentially severe treatment‐related toxicity. We report our institutional experience of reirradiation using modern highly conformal radiotherapy approaches in patients with prior oropharyngeal radiation. Methods: We reviewed patients receiving curative‐intent reirradiation with intensity‐modulated radiation therapy, stereotactic body radiation therapy, and proton beam radiotherapy at our institution from 1999 to 2019. Disease control, survival, and toxicity rates following reirradiation were determined. Results: Sixty‐nine patients were evaluated. Local control (LC), progression‐free survival, and overall survival at 2 years following reirradiation were 77%, 35%, and 51%, respectively. Grade 3 or greater (G3+) late toxicities occurred in 46% of patients and 41% required feeding tube placement during or after reirradiation. Conclusions: In select patients with prior oropharyngeal radiation, highly conformal reirradiation offers acceptable LC, but G3+ toxicity and out‐of‐field failure rates remain high. These findings warrant continued evaluation of new multimodality approaches to improve oncologic outcomes.