ArticleInternational journal of radiation oncology, biology, physics2018
Volume, Dose, and Fractionation Considerations for IMRT-based Reirradiation in Head and Neck Cancer: A Multi-institution Analysis.
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 46 papers, 2 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prognostic models for radiation-induced complications after radiotherapy in head and neck cancer patients.The Cochrane database of systematic reviews · 2025Pooled it
- Evidence-based guideline diagnosis, treatment, prevention and aftercare of oropharyngeal and hypopharyngeal carcinoma.German medical science : GMS e-journal · 2025Guideline
- Reirradiation With Proton Therapy Using Hypofractionated Schedules: A Systematic Review of the Literature.International journal of particle therapy · 2026Review
- Salvage of locoregionally recurrent head and neck cancer: an NRG oncology working group review.Journal of the National Cancer Institute · 2026Review
- Positron emission tomography directed re-irradiation using volumetric modulated arc technique in recurrent head and neck squamous cell carcinoma.Scientific reports · 2025Article
- Optimising (re-)irradiation for locally recurrent head and neck cancer: impact of dose-escalation, salvage surgery, PEG tube and biomarkers on oncological outcomes-a single centre analysis.Radiation oncology (London, England) · 2025Article
- Recurrent Versus Metastatic Head and Neck Cancer: An Evolving Landscape and the Role of Immunotherapy.Biomedicines · 2024Review
- Feasibility and flexibility of a novel multi-dose level avoidance reirradiation technical methodology in recurrent head and neck cancer.BJR case reports · 2024Article
- Stereotactic ablative radiotherapy for treating primary head and neck cancer and locoregional recurrence: A comprehensive review of the literature.Clinical and translational radiation oncology · 2024Article
- A comparative dose-escalation analysis for reirradiated cancer patients with and without appropriate dose mapping.Radiation and environmental biophysics · 2024Article
- Re-irradiation for isolated neck recurrence in head and neck tumor: impact of rN category.Scientific reports · 2024Article
- Reirradiation of head and neck squamous cell carcinomas: a pragmatic approach-part I: prognostic factors and indications to treatment.La Radiologia medica · 2024Review
- Advancements of radiotherapy for recurrent head and neck cancer in modern era.Radiation oncology (London, England) · 2023Review
- Review
- Impact of hyperfractionated re-irradiation on quality of life in patients with recurrent or second primary head and neck cancer, a prospective single institutional study.Clinical and translational radiation oncology · 2023Article
- Reirradiation of head and neck squamous cell carcinomas: a pragmatic approach, part II: radiation technique and fractionations.La Radiologia medica · 2023Review
- Management of Recurrent HPV-Positive Oropharyngeal Squamous Cell Carcinoma: a Contemporary Review.Current oncology reports · 2023Review
- Induction therapy in recurrent head and neck squamous cell carcinoma: is it time to consider response as a determinant of treatment selection?Translational cancer research · 2023Article
- Reirradiation for local recurrence of oral, pharyngeal, and laryngeal cancers: a multi-institutional study.Scientific reports · 2023Article
- Re-irradiation for head and neck cancer: outcome and toxicity analysis using a prospective single institution database.Frontiers in oncology · 2023Article
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Abstract
purposeLimited data exist to guide the treatment technique for reirradiation of recurrent or second primary squamous carcinoma of the head and neck. We performed a multi-institution retrospective cohort study to investigate the effect of the elective treatment volume, dose, and fractionation on outcomes and toxicity. METHODS AND MATERIALS: Patients with recurrent or second primary squamous carcinoma originating in a previously irradiated field (≥40 Gy) who had undergone reirradiation with intensity modulated radiation therapy (IMRT); (≥40 Gy re-IMRT) were included. The effect of elective nodal treatment, dose, and fractionation on overall survival (OS), locoregional control, and acute and late toxicity were assessed. The Kaplan-Meier and Gray's competing risks methods were used for actuarial endpoints.
resultsFrom 8 institutions, 505 patients were included in the present updated analysis. The elective neck was not treated in 56.4% of patients. The median dose of re-IMRT was 60 Gy (range 39.6-79.2). Hyperfractionation was used in 20.2%. Systemic therapy was integrated for 77.4% of patients. Elective nodal radiation therapy did not appear to decrease the risk of locoregional failure (LRF) or improve the OS rate. Doses of ≥66 Gy were associated with improvements in both LRF and OS in the definitive re-IMRT setting. However, dose did not obviously affect LRF or OS in the postoperative re-IMRT setting. Hyperfractionation was not associated with improved LRF or OS. The rate of acute grade ≥3 toxicity was 22.1% overall. On multivariable logistic regression, elective neck irradiation was associated with increased acute toxicity in the postoperative setting. The rate of overall late grade ≥3 toxicity was 16.7%, with patients treated postoperatively with hyperfractionation experiencing the highest rates.
conclusionsDoses of ≥66 Gy might be associated with improved outcomes in high-performance patients undergoing definitive re-IMRT. Postoperatively, doses of 50 to 66 Gy appear adequate after removal of gross disease. Hyperfractionation and elective neck irradiation were not associated with an obvious benefit and might increase toxicity.
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