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50th International Scientific Conference on Sport, Medical and Health Sciences Vennue: Hotel Grand Flora Dubai, UAE Al- Rigga Road Deira , Near Al-Rigga Metro station , Deira Dubai UAE Date: 20-Dec-2018 More Details
7th International Academic Conference on Medical and Health Sciences Vennue: Hotel Istana Kuala Lumpur City Centre 73 Jalan Raja Chulan, Kuala Lumpur, 50200, Malaysia Date: 29-Dec-2018 More Details
Introduction: Loco-regional failures, recurrence or second primary after radiotherapy (RT) is a significant problem in head and neck cancer (HNC) and represent a challenge. Methods: 39 patients were referred to the Radiation Oncology Department, A. C. Camargo Cancer Center, Sao Paulo, Brazil between 2007 to 2012 to have a second new course of RT (Re-RT) to a previous irradiated area in the head and neck. Results: Median age of patients was 53.8 (range, 31-74) years. Twenty four (61.5%) patients had surgery and Re-RT. The first radiation course dose ranged from 45 Gy to 72 Gy (median 60.0 Gy) and the median interval between the initial and second radiation course was 32 (range, 9-146) months. The median follow-up was 2.6 (range, 0.5-5.9) years. The 2- and 5-year actuarial OS, PFS and LC rates were 76.0%, 38.6%, 83.8%, 75.0%, 27.0% and 14.0%, respectively. Re-RT with IMRT when compared to other techniques showed PFS and LC advantages, p= 0.018 and p=0.019, respectively, confirmed by Cox regression multivariate - HR=6.08 (p= 0.020, 95% CI: 1.331- 27.767). Major toxicity occurred in 14 (35.9%) patients and eye observed no carotid artery blowout in this series. Conclusion: Re-RT should be offered for patients who are not suitable for surgery or for those with marginal resections, with a clear understanding that survival is poor and many of these patients will suffer severe radiation-related insults to their quality of life, during and after treatment.
This study contributes in the existing literature by analyzing the impact of new technologies in the local control of recurrent head and neck cancer.
W. J. Goodwin, "Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: When do the ends justify the means," Laryngoscope, vol. 110, pp. 1–18, 2000.
L. Wong, W. Wei, L. Lam, and A. Yuen, "Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery," Head Neck, vol. 25, pp. 953–959, 2003.
J. Parsons, W. Mendenhall, S. Stringer, N. Cassisi, and R. Million, "Salvage surgery following radiation failure in squamous cell carcinoma of the supraglottic larynx," Int. J. Radiat. Oncol. Biol. Phys., vol. 32, pp. 605–60, 1995.
P. Stell, "Survival times in end-stage head and neck cancer," Eur. J. Surg. Oncol., vol. 15, pp. 407–410, 1989.
A. Forastiere, B. Metch, D. Schuller, J. Ensley, L. Hutchins, P. Triozzi, J. Kish, S. McClure, E. VonFeldt, S. Williamson, and D. Von Hoff, "Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck: A Southwest oncology group study," J. Clin. Oncol., vol. 10, pp. 1245–1251, 1992.
T. Hehr, J. Classen, C. Belka, S. Welz, J. Schäfer, A. Koitschev, M. Bamberg, and W. Budach, "Reirradiation alternating with docetaxel and cisplatin in inoperable recurrence of head-and-neck cancer: A prospective phase I/II trial," Int. J. Radiat. Oncol. Biol. Phys., vol. 61, pp. 1423–1431, 2005.
A. Pellizzon, P. Dos Santos Novaes, M. Conte Maia, R. Ferrigno, R. Fogarolli, J. Salvajoli, and L. Kowalski, "Interstitial high-dose-rate brachytherapy combined with cervical dissection on head and neck cancer," Head Neck, vol. 27, pp. 1035-1041, 2005.
N. Lee, K. Chan, J. Bekelman, J. Zhung, J. Mechalakos, A. Narayana, S. Wolden, E. Venkatraman, D. Pfister, D. Kraus, J. Shah, and M. Zelefsky, "Salvage re-irradiation for recurrent head and neck cancer," Int. J. Radiat. Oncol. Biol. Phys., vol. 68, pp. 731–740, 2007.
E. Sulman, D. Schwartz, T. Le, K. Ang, W. Morrison, D. Rosenthal, A. Ahamad, M. Kies, B. Glisson, R. Weber, and A. Garden, "IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes," Int. J. Radiat. Oncol. Biol. Phys., vol. 73, pp. 399-409, 2009.
M. Biagioli, M. Harvey, E. Roman, L. Raez, A. Wolfson, S. Mutyala, H. Han, and A. Markoe, "Modulated radiotherapy with concurrent chemotherapy for previously irradiated, recurrent head and neck cancer," Int. J. Radiat. Oncol. Biol. Phys., vol. 69, pp. 1067–1073, 2007.
J. Salama, E. Vokes, S. Chmura, M. Milano, J. Kao, K. Stenson, M. Witt, and D. Haraf, "Long-term outcome of concurrent chemotherapy and reirradiation for recurrent and second primary head-and-neck squamous cell carcinoma," Int. J. Radiat. Oncol. Biol. Phys., vol. 64, pp. 382–391, 2006.
S. Spencer, J. Harris, R. Wheeler, M. Machtay, C. Schultz, W. Spanos, M. Rotman, R. Meredith, and K. Ang, "Final report of RTOG 9610, a multi-institutional trial of reirradiation and chemotherapy for unresectable recurrent squamous cell carcinoma of the head and neck," Head Neck, vol. 30, pp. 281–288, 2008.
C. Langer, J. Harris, E. Horwitz, N. Nicolaou, M. Kies, W. Curran, S. Wong, and K. Ang, "Phase II study of low-dose paclitaxel and cisplatin in combination with split-course concomitant twice-daily reirradiation in recurrent squamous cell carcinoma of the head and neck: Results of radiation therapy oncology group protocol 9911," J. Clin. Oncol., vol. 25, pp. 4800–4805, 2007.
U. Schaefer, O. Micke, P. Schueller, and N. Willich, "Recurrent head and neck cancer: Retreatment of previously irradiated areas with combined chemotherapy and radiation therapy-results of a prospective study," Radiology, vol. 216, pp. 371–378, 2000.
J. Kao, M. Garofalo, M. Milano, S. Chmura, J. Citron, and D. Haraf, "Reirradiation of recurrent and second primary head and neck malignancies: A comprehensive review," Cancer Treat Rev., vol. 29, pp. 21–30, 2003.
J. Skolyszewski, S. Korzeniowski, and M. Reinfuss, "The reirradiation of recurrences of head and neck cancer," Br. J. Radiol., vol. 53, pp. 462–465, 1980.
D. Goldstein, L. Karnell, M. Yao, G. Chamberlin, T. Nguyen, and G. Funk, "Outcomes following reirradiation of patients with head and neck cancer," Head Neck, vol. 30, pp. 765–770, 2008.
K. J. Stevens, A. Britsch, and W. Moss, "High-dose reirradiation of head and neck cancer with curative intent," Int. J. Radiat. Oncol. Biol. Phys., vol. 29, pp. 687–698, 1994.
M. Biagioli, M. Harvey, E. Roman, L. Raez, A. Wolfson, S. Mutyala, H. Han, and A. Markoe, "Intensity-modulated radiotherapy with concurrent chemotherapy for previously irradiated, recurrent head and neck cancer," Int. J. Radiat. Oncol. Biol. Phys., vol. 69, pp. 1067-1073, 2007.
A. Popovtzer, I. Gluck, D. Chepeha, T. Teknos, J. Moyer, M. Prince, C. Bradford, and A. Eisbruch, "The pattern of failure after reirradiation of recurrent squamous cell head and neck cancer: Implications for defining the targets," Int. J. Radiat. Oncol. Biol. Phys., vol. 74, pp. 1342-1347, 2009.