ArticleInternational journal of radiation oncology, biology, physics2018
Refining Patient Selection for Reirradiation of Head and Neck Squamous Carcinoma in the IMRT Era: A Multi-institution Cohort Study by the MIRI Collaborative.
Article in International journal of radiation oncology, biology, physics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.
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Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Evidence-based guideline diagnosis, treatment, prevention and aftercare of oropharyngeal and hypopharyngeal carcinoma.German medical science : GMS e-journal · 2025Guideline
- A systematic review and practical considerations of stereotactic body radiotherapy in the treatment of head and neck cancer.The British journal of radiology · 2021Pooled it
- Phase II clinical trial assessing the addition of hyperthermia to salvage concurrent chemoradiotherapy for unresectable recurrent head and neck cancer in previously irradiated patients.Radiation oncology (London, England) · 2025Trial
- Neoadjuvant and Adjuvant Nivolumab and Lirilumab in Patients with Recurrent, Resectable Squamous Cell Carcinoma of the Head and Neck.Clinical cancer research : an official journal of the American Association for Cancer Research · 2022Trial
- Current role of boron neutron capture therapy in head and neck cancer: insights from 4 years of clinical experience.Clinical and translational radiation oncology · 2027Article
- The feasibility and toxicity of the second course of boron neutron capture therapy in recurrent head and neck cancer patients.Journal of radiation research · 2026Article
- Integration of geriatric nutritional risk index and sarcopenia for prognostic assessment in nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: a large-scale long-term retrospective study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Cerebrovascular Accident Risk in Survivors of Head and Neck Cancer: JACC CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2026Review
- Article
- Salvage of locoregionally recurrent head and neck cancer: an NRG oncology working group review.Journal of the National Cancer Institute · 2026Review
- Article
- A Podcast Discussion on Medical Treatment in R/M-SCCHN in the Year 2025-Standard and Considerations for an Individualized Treatment.Oncology and therapy · 2026Article
- Challenges in recurrent head and neck squamous cell cancer treatment: systematic review andClinical and translational radiation oncology · 2026Review
- Predicting tumor recurrence site after reirradiation in head and neck cancer: a retrospective external validation of a published [18F]-FDG PET radiomic signature.La Radiologia medica · 2025Article
- Predictive factors of oral mucositis in patients with locally recurrent inoperable head and neck cancer treated with boron neutron capture therapy.Acta oncologica (Stockholm, Sweden) · 2025Article
- MK2 promotes p16 negative head and neck cancer migration, invasion, and metastasis.Cancer letters · 2025Article
- Positron emission tomography directed re-irradiation using volumetric modulated arc technique in recurrent head and neck squamous cell carcinoma.Scientific reports · 2025Article
- Article
- Successful Treatment With Single-Fraction Stereotactic Body Radiotherapy to Lung and Reirradiation of Neck Node Metastases in a Treated Base Tongue Primary.Case reports in oncological medicine · 2025Article
- Re-irradiation in head and neck cancer: thirteen years of insights.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
24 authors.
Funding
Abstract
purposeThe therapeutic ratio of reirradiation for recurrent or second primary (RSP) squamous carcinoma of the head and neck may be improved in the intensity modulated radiation therapy (IMRT) era. However, patient selection for reirradiation remains challenging. We performed a multi-institution cohort study to investigate modern outcomes after IMRT-based reirradiation and to identify prognostic subgroups. PATIENTS AND
methodsPatients with RSP squamous carcinoma originating in a previously irradiated field (≥40 Gy) who underwent reirradiation with IMRT (≥40 Gy re-IMRT) were included. Locoregional failure and late toxicity were calculated using the Gray competing risk method. Cox proportional hazards regression was used to identify factors associated with overall survival (OS). Factors associated with OS were entered into a recursive partitioning analysis (RPA) for OS.
resultsFrom 7 institutions, 412 patients were included. The median dose of re-IMRT was 60 Gy, and the median time between RT courses was 2.4 years. Chemotherapy was used in 76% of patients. The rates of grade ≥3, grade ≥4, and grade 5 acute toxicities were 19%, 4.4%, and 1.2%, respectively. The 2-year cumulative incidence of grade ≥3 late toxicity adjusted for the competing risks of recurrence or death was 14.2%. RPA identified 3 prognostic subgroups with distinct and homogenous OS (P<.001): class I included patients >2 years from their initial course of RT with resected tumors (2-year OS, 61.9%); class II included patients >2 years with unresected tumors or those ≤2 years and without feeding tube or tracheostomy dependence (2-year OS, 40.0%), and the remaining patients formed class III (2-year OS, 16.8%). Fifty-nine percent of class III patients underwent postoperative re-irradiation.
conclusionsThis study informs outcomes and expectations with IMRT-based reirradiation. The RPA classification identifies 3 distinct subgroups, which can guide patient selection for therapy and clinical trial design. RPA class III patients are not ideal candidates for protracted chemoradiation regardless of resection status.
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