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| Home > Publications database > Carbon Ion Re-Irradiation for Recurrent Head-and-Neck Cancer: A Single-Institutional Experience. |
| Home > Publications database > Carbon Ion Re-Irradiation for Recurrent Head-and-Neck Cancer: A Single-Institutional Experience. |
| Journal Article | DKFZ-2019-01892 |
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2019
Elsevier Science
Amsterdam [u.a.]
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Please use a persistent id in citations: doi:10.1016/j.ijrobp.2019.07.021
Abstract: This study aimed to assess the feasibility of carbon ion re-irradiation (CIR) for recurrent head and neck cancer (HNC).This retrospective study included 229 patients with recurrent HNC that were treated with CIR between 2010 and 2017. We assessed progression-free survival (PFS), overall survival (OS), pattern of failure, and toxicity. Of the primary tumors, 54.1% were adenoid cystic carcinomas, 26.2% were squamous cell carcinomas, 8.3% were adenocarcinomas, and 11.4% were other tumor entities.The median radiotherapy interval was 3.9 years (range, 0.3-46.5 years), and patients received a median dose of 51 Gy (relative biological effectiveness [RBE]; range, 30-66 Gy [RBE]) in 3 Gy (RBE) fractions. The median cumulative lifetime dose after CIR was 132.8 Gy (range, 88.8-155.0 Gy). The median local PFS after CIR was 24.2 months (95% confidence interval [CI] 19.4-29.0 months), and the median OS was 26.1 months (95% CI 21.9-30.3 months). Serious acute toxicity (≥ grade III) after CIR included laryngeal edema, grade IV (n = 2; 0.9%); dysphagia, grade III (n = 3; 1.3%); fistula, grade III (n = 1; 0.4%); and impaired hearing, grade III (n = 1; 0.4%). Late toxicities of grades III or higher (n = 18; 14.5%) included central nervous system necrosis, grades IV/III (n = 1; 0.8%/n = 5; 4.0%); optic nerve disorder, grades IV/III (n = 2; 1.6%/n = 2; 1.6%); impaired hearing, grade III (n = 5; 4.0%), osteonecrosis, grade III (n = 1; 0.8%); and carotid blowout, grade IV (n = 1; 0.8%).In patients with locally recurrent HNC, CIR was a feasible, effective treatment with acceptable toxicity and good local control. Thus, CIR represented a valuable alternative to surgical salvage and palliative chemotherapy in selected patients.
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