Re-irradiation for head and neck squamous cell carcinoma

Rony Benson; Prashant Giridhar; Bhanu Prasad Venkatesulu; Supriya Mallick; Mohd Waseem Raza; Goura Kishor Rath

doi:10.1016/j.jnci.2016.07.002

Re-irradiation for head and neck squamous cell carcinoma

J Egypt Natl Canc Inst. 2017 Mar;29(1):1-9. doi: 10.1016/j.jnci.2016.07.002. Epub 2016 Aug 29.

Authors

Rony Benson¹, Prashant Giridhar¹, Bhanu Prasad Venkatesulu¹, Supriya Mallick², Mohd Waseem Raza¹, Goura Kishor Rath¹

Affiliations

¹ Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
² Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: drsupriyamallick@gmail.com.

PMID: 27595192
DOI: 10.1016/j.jnci.2016.07.002

Abstract

Introduction: Local recurrences after curative treatment have a potential for cure with salvage surgery or with re-irradiation.

Methods: We reviewed the PubMed for articles published in English with key words squamous cell carcinoma, recurrent, re-irradiation, prognostic factors to find relevant articles describing prognostic factors, re-irradiation, and outcome for recurrent head and neck squamous cell carcinoma.

Results: Various factors including age, performance status, time for recurrence, previous radiation dose volume and site of recurrence, previous use of chemotherapy are all prognostic factors in recurrent head and neck squamous cell carcinoma. Surgery is feasible in very select subgroup of patients and must be done when feasible. Re-irradiation with the aid of modern sophisticated technology is safe and confers durable and clinically meaningful survival benefit. Re-irradiation in head and neck recurrent squamous cell carcinoma may provide an expected median survival of 10-12months. Chemotherapy may be added along with radiation in the recurrent setting.

Conclusion: Treatment approaches may have to be personalized. Re surgery must be done in all patients in whom it is feasible. In patients in whom surgery is not feasible, re-irradiation must be evaluated as a therapeutic option especially in patients with limited volume recurrence.

Keywords: Re-irradiation; Recurrent; Squamous cell carcinoma; Toxicity.

Publication types

Meta-Analysis
Review

MeSH terms

Biopsy
Carcinoma, Squamous Cell / diagnosis
Carcinoma, Squamous Cell / mortality
Carcinoma, Squamous Cell / radiotherapy*
Combined Modality Therapy
Dose Fractionation, Radiation
Head and Neck Neoplasms / diagnosis
Head and Neck Neoplasms / mortality
Head and Neck Neoplasms / radiotherapy*
Humans
Multimodal Imaging
Neoplasm Staging
Neoplasms, Second Primary / etiology
Organs at Risk
Patient Selection
Postoperative Care
Prognosis
Re-Irradiation* / adverse effects
Re-Irradiation* / methods
Recurrence
Salvage Therapy
Treatment Outcome