Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer Research

Background:

• Salvage re-irradiation (rRT) for locoregionally recurrent head and neck cancer (rHNC) presents significant clinical challenges.
• Assessing the efficacy and toxicity of rRT is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the outcomes of salvage re-irradiation in patients with locoregionally recurrent head and neck cancer.
• To identify prognostic factors for overall survival and disease-free survival after rRT.
• To assess the rate of severe late toxicities associated with rRT.

Main Methods:

• Retrospective analysis of 49 patients treated with rRT between 2011 and 2018.
• Co-primary endpoints: 2-year freedom from cancer recurrence rate (FCRR) and overall survival (OS).
• Secondary endpoints included disease-free survival (DFS), local failure (LF), regional failure (RF), distant metastases (DM), and severe late toxicities.

Main Results:

• The 2-year FCRR was 64%, with an OS of 51%.
• Significant predictors for worse OS included poor performance status (PS) and age > 52 years.
• Poor PS and a total rRT dose < 60 Gy predicted worse DFS. Grade ≥3 late toxicity occurred in 18.3% of patients.

Conclusions:

• Salvage re-irradiation for rHNC demonstrated a promising 2-year FCRR, suggesting its value as a key endpoint in future studies.
• The treatment was relatively successful in this cohort, with a manageable level of severe late toxicity.
• rRT is a viable and potentially successful treatment option for rHNC, particularly in resource-limited settings.