ArticleRadiation oncology (London, England)2025
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.
Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Article
- Preliminary observations on peripheral inflammatory markers in NIR-PIT and ICI-treated recurrent head and neck squamous cell carcinoma.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
- Challenges in recurrent head and neck squamous cell cancer treatment: systematic review andClinical and translational radiation oncology · 2026Review
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Authors and funding
13 authors.
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Abstract
introductionLocoregional recurrence (LR) is common in locally advanced head and neck cancer (HNSCC), posing challenges for treatment. We analysed outcome parameters and toxicities for patients being treated with radiotherapy (RT) for LR-HNSCC and investigated patient and disease related prognostic factors in this prognostically unfavourable group.
methodsThis analysis includes 101 LR-HNSCC patients treated with RT, radio-chemotherapy (RCT) or radio-immunotherapy (RIT) between 2010 and 2018 at a high-volume tertiary centre. Patient characteristics, tumour and treatment details were retrospectively collected. Overall survival (OS), progression-free survival (PFS) and toxicities according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0 were assessed.
results62% of patients were radiotherapy-naïve (initial RT group) while 38% were re-irradiated at site of LR (re-RT group). Median OS for initial RT was 24 months, for re-RT 12 months (p < 0.01). In the RCT subgroup, patients with initial RT had significantly longer OS with 35 months compared to re-RT 12 months (p < 0.05). Patients with UICC grade IV tumours and percutaneous endoscopic gastrostomy (PEG) tube had significantly shorter OS in multivariate analysis: initial RT 13 vs. re-RT 32 months and initial RT 12 vs. re-RT 32 months respectively. Salvage surgery before RT at recurrence was a positive prognostic factor for OS (initial RT 35 vs. re-RT 12 months). Other significant factors for longer OS in univariate analysis included low inflammatory status (Glasgow Prognostic Score 0) and radiation doses ≥ 50 Gy. We detected 37 (15%) ≥ CTCAE Grade 3 events for initial RT and 19 (15%) for re-RT patients.
conclusionIn this analysis, we identified key prognostic factors including PEG tube and inflammation status that could guide treatment decision. Our findings suggest salvage surgery as preferred treatment option with postoperative RT at LR. Adverse events due to re-RT were acceptable. A radiation dose of ≥ 50 Gy should be administered to achieve better outcomes.
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