Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes
Objectives. Locoregional recurrence is the predominant pattern of treatment failure in advanced head and neck cancers. Reirradiation is a useful modality to treat inoperable head and neck cancer patients with recurrent disease. The aim of the present study was to analyze the treatment toxicity and e...
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doaj-5cd3d66154054d23aed3825b602c63c32020-11-24T21:22:20ZengHindawi LimitedJournal of Oncology1687-84501687-84692018-01-01201810.1155/2018/81836948183694Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical OutcomesAmit Bahl0Arun Singh Oinam1Arun Elangovan2Satinder Kaur3Gaurav Trivedi4Roshan Verma5Sudhir Bhandari6Sushmita Ghoshal7Naresh Kumar Panda8Department of Radiation Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Radiation Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Radiation Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Radiation Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Radiation Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Oral Health Sciences, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Radiation Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaObjectives. Locoregional recurrence is the predominant pattern of treatment failure in advanced head and neck cancers. Reirradiation is a useful modality to treat inoperable head and neck cancer patients with recurrent disease. The aim of the present study was to analyze the treatment toxicity and early clinical outcomes in patients undergoing reirradiation. Methods. Twenty patients of head and neck cancers with recurrences or second cancers were evaluated. Reirradiation was done using simultaneous integrated boost volumetric modulated arc therapy (SIB VMAT), intensity modulated radiotherapy (IMRT), or conventional radiotherapy using 6MV photons. Dose prescription ranged from 30 to 60 Gy in conventional fractionation. Results. Seventeen males and three females were evaluated in this analysis. The median age of patients under study was 56.5 years. At time of analysis 8 patients (40%) had a complete response, 7 patients (35%) had progressive disease, and 25% had partial response or stable disease. Grade III-IV mucositis, dermatitis, xerostomia, dysphagia, and trismus were seen in 20%, 20%, 50%, 35%, and 45% patients, respectively, during retreatment. Patients receiving a radiotherapy dose less than 45 Gy showed a higher incidence of progressive disease (p=0.01). The median disease-free survival for patients receiving reirradiation dose of ≥46 Gy was 19±3.3 months (median ± S Error) compared to 8±2.61 months for those with a dose prescription less than 45 Gy (p=0.03). At 18-month follow-up 26% of patients undergoing reirradiation were disease-free. Conclusions. Our results show improved tumor control using a prescription of doses ≥46 Gy in retreatment setting.http://dx.doi.org/10.1155/2018/8183694 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amit Bahl Arun Singh Oinam Arun Elangovan Satinder Kaur Gaurav Trivedi Roshan Verma Sudhir Bhandari Sushmita Ghoshal Naresh Kumar Panda |
spellingShingle |
Amit Bahl Arun Singh Oinam Arun Elangovan Satinder Kaur Gaurav Trivedi Roshan Verma Sudhir Bhandari Sushmita Ghoshal Naresh Kumar Panda Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes Journal of Oncology |
author_facet |
Amit Bahl Arun Singh Oinam Arun Elangovan Satinder Kaur Gaurav Trivedi Roshan Verma Sudhir Bhandari Sushmita Ghoshal Naresh Kumar Panda |
author_sort |
Amit Bahl |
title |
Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes |
title_short |
Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes |
title_full |
Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes |
title_fullStr |
Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes |
title_full_unstemmed |
Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes |
title_sort |
evaluation of reirradiation in locally advanced head and neck cancers: toxicity and early clinical outcomes |
publisher |
Hindawi Limited |
series |
Journal of Oncology |
issn |
1687-8450 1687-8469 |
publishDate |
2018-01-01 |
description |
Objectives. Locoregional recurrence is the predominant pattern of treatment failure in advanced head and neck cancers. Reirradiation is a useful modality to treat inoperable head and neck cancer patients with recurrent disease. The aim of the present study was to analyze the treatment toxicity and early clinical outcomes in patients undergoing reirradiation. Methods. Twenty patients of head and neck cancers with recurrences or second cancers were evaluated. Reirradiation was done using simultaneous integrated boost volumetric modulated arc therapy (SIB VMAT), intensity modulated radiotherapy (IMRT), or conventional radiotherapy using 6MV photons. Dose prescription ranged from 30 to 60 Gy in conventional fractionation. Results. Seventeen males and three females were evaluated in this analysis. The median age of patients under study was 56.5 years. At time of analysis 8 patients (40%) had a complete response, 7 patients (35%) had progressive disease, and 25% had partial response or stable disease. Grade III-IV mucositis, dermatitis, xerostomia, dysphagia, and trismus were seen in 20%, 20%, 50%, 35%, and 45% patients, respectively, during retreatment. Patients receiving a radiotherapy dose less than 45 Gy showed a higher incidence of progressive disease (p=0.01). The median disease-free survival for patients receiving reirradiation dose of ≥46 Gy was 19±3.3 months (median ± S Error) compared to 8±2.61 months for those with a dose prescription less than 45 Gy (p=0.03). At 18-month follow-up 26% of patients undergoing reirradiation were disease-free. Conclusions. Our results show improved tumor control using a prescription of doses ≥46 Gy in retreatment setting. |
url |
http://dx.doi.org/10.1155/2018/8183694 |
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