IMRT Reirradiation of Head and Neck Cancer-Disease Control and Morbidity Outcomes

Erik P. Sulman, David Schwartz, Thuy T. Le, K. Kian Ang, William H. Morrison, David I. Rosenthal, Anesa Ahamad, Merril Kies, Bonnie Glisson, Randal Weber, Adam S. Garden

Research output: Contribution to journalArticle

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Abstract

Purpose: Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients. Methods and Materials: Records of 78 consecutive patients reirradiated with IMRT for head and neck cancer between 1999 and 2004 were reviewed; 74 cases were analyzed. Reirradiation was defined as any overlap between original and new radiation treatment volumes regardless of the time interval between initial and subsequent treatment. Severe reirradiation-related toxicity was defined as toxic events resulting in hospitalization, corrective surgery, or patient death. Longitudinal estimates of survival were calculated by Kaplan-Meier technique. Results: Twenty (27%) patients underwent salvage surgical resection and 36 (49%) patients received chemotherapy. Median follow-up from reirradiation was 25 months. Median time interval between initial radiation and reirradiation was 46 months. Median reirradiation dose was 60 Gy. Median lifetime radiation dose was 116.1 Gy. The 2-year overall survival and locoregional control rates were 58% and 64%, respectively. Severe reirradiation related toxicity occurred in 15 patients (20%); one treatment-related death was observed. Conclusions: The use of IMRT for reirradiation of recurrent or second primary head and neck cancers resulted in encouraging local control and survival. Reirradiation-related morbidity was significant, but may be less severe than previously published reports using conventional techniques.

Original languageEnglish (US)
Pages (from-to)399-409
Number of pages11
JournalInternational Journal of Radiation Oncology Biology Physics
Volume73
Issue number2
DOIs
StatePublished - Feb 1 2009

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Intensity-Modulated Radiotherapy
Head and Neck Neoplasms
radiation therapy
cancer
Morbidity
death
toxicity
radiation
Radiation
intervals
dosage
Survival
chemotherapy
surgery
Re-Irradiation
indication
Second Primary Neoplasms
Poisons
life (durability)
Hospitalization

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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IMRT Reirradiation of Head and Neck Cancer-Disease Control and Morbidity Outcomes. / Sulman, Erik P.; Schwartz, David; Le, Thuy T.; Ang, K. Kian; Morrison, William H.; Rosenthal, David I.; Ahamad, Anesa; Kies, Merril; Glisson, Bonnie; Weber, Randal; Garden, Adam S.

In: International Journal of Radiation Oncology Biology Physics, Vol. 73, No. 2, 01.02.2009, p. 399-409.

Research output: Contribution to journalArticle

Sulman, EP, Schwartz, D, Le, TT, Ang, KK, Morrison, WH, Rosenthal, DI, Ahamad, A, Kies, M, Glisson, B, Weber, R & Garden, AS 2009, 'IMRT Reirradiation of Head and Neck Cancer-Disease Control and Morbidity Outcomes', International Journal of Radiation Oncology Biology Physics, vol. 73, no. 2, pp. 399-409. https://doi.org/10.1016/j.ijrobp.2008.04.021
Sulman, Erik P. ; Schwartz, David ; Le, Thuy T. ; Ang, K. Kian ; Morrison, William H. ; Rosenthal, David I. ; Ahamad, Anesa ; Kies, Merril ; Glisson, Bonnie ; Weber, Randal ; Garden, Adam S. / IMRT Reirradiation of Head and Neck Cancer-Disease Control and Morbidity Outcomes. In: International Journal of Radiation Oncology Biology Physics. 2009 ; Vol. 73, No. 2. pp. 399-409.
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