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Chemo-reirradiation in persistent/recurrent head and neck cancers.
Yoodhvir Singh Nagar1, Shalini Singh, Niloy Ranjan Datta
1Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. ysnagar@yahoo.com
Japanese Journal of Clinical Oncology
|April 7, 2004
Summary
Chemo-reirradiation is a feasible and effective salvage treatment for persistent head and neck cancers. Optimal reirradiation doses (>/=100 Gy) with chemotherapy show promising results, especially for patients previously treated with external radiotherapy.
Area of Science:
- Oncology
- Radiation Oncology
- Head and Neck Cancer Treatment
Background:
- Persistent or recurrent head and neck cancers pose a significant challenge after initial curative therapy.
- Salvage treatment options are limited, necessitating evaluation of novel approaches.
Purpose of the Study:
- To assess the feasibility and safety of chemo-reirradiation as a salvage treatment for persistent/recurrent head and neck cancers.
- To evaluate the efficacy of chemo-reirradiation in terms of response rates and survival outcomes.
Main Methods:
- Retrospective analysis of 131 patients with loco-regional persistent/recurrent head and neck carcinoma treated between 1991-1999.
- 29 patients received chemo-reirradiation and were evaluated for toxicity, post-salvage survival, and overall survival.
Main Results:
- Chemo-reirradiation showed an 83% overall response rate, with 31% complete response, particularly in patients previously treated with external radiotherapy (54% complete response).
- Median post-salvage overall survival was 9 months, with 1- and 2-year survival rates of 41% and 12%, respectively.
- Grade 2/3 toxicities (mucositis, dermatitis, neutropenia) were observed in 10%, 7%, and 3% of patients, respectively.
Conclusions:
- Chemo-reirradiation is a feasible and effective salvage strategy for selected patients with head and neck cancers previously treated with external radiotherapy.
- Achieving cumulative doses of >=100 Gy with chemotherapy is crucial for optimal outcomes.
- Further prospective trials are warranted to confirm these findings and refine patient selection.