Re-irradiation in H&N cancer: A retrospective outcome analysis using a single institutional database
Daniel Zwahlen,
Switzerland
PO-1173
Abstract
Re-irradiation in H&N cancer: A retrospective outcome analysis using a single institutional database
Authors: Daniel Zwahlen1, Chiara Scolari1, Christina Schröder1, Robert Förster1, André Buchali2
1Kantonsspital Winterthur, Department of Radiation Oncology, Winterthur, Switzerland; 2Ruppiner Kliniken GmbH, Department of Radiation Oncology, Neuruppin, Germany
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Purpose or Objective
To evaluate clinical outcome and toxicity in patients treated with re-irradiation (re-RT) for loco-regionally recurrent or second primary head and neck cancer (LRR/SP HNC) at a single institution.
Material and Methods
Retrospective analysis of 63 LRR/SP HNC patients who underwent definitive or postoperative twice daily hyperfractionated (chemo)-re-RT between 2001 and 2022. Overall survival (OS), progression-free survival (PFS), locoregional control (LRC) and distant metastasis control (DMC) were analyzed and prognostic factors were evaluated. Acute and late toxicity were prospectively collected.
Results
The median follow-up was 8.6 months. Two-year OS, PFS and LRC were 20%, 19% and 31%, respectively. Multivariate analysis revealed recurrent T stage 0-3, chemotherapy and re-RT dose of 60 Gy as significant favorable factors for OS (all p < 0.005). In addition to these factors, recurrent N stage 0-1, overall stage I-III and a longer disease-free interval (>24 months) were significantly associated with improved PFS (all p < 0.005). All these factors, except re-RT dose, were significantly associated with better LRC. At least one new grade ≥3 acute toxicity was observed in 37 patients (69%) comprising mostly dysphagia and/or mucositis. Late toxicity included grade ≥3 dysphagia in 7.1% of evaluable patients and osteoradionecrosis in 9.5%.
Conclusion
The use of re-RT may be a curative treatment option with acceptable toxicity only for well-selected patients.