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@ARTICLE{Roesch:182237,
      author       = {J. Roesch and M. Oertel and S. Wegen and M. Trommer and J.
                      Schleifenbaum and D. Hering and M. Mäurer and S. Knippen
                      and S. Dobiasch and M. Waltenberger and J. von der Grün and
                      D. Medenwald and C. Süß and M. Hoeck and L. Käsmann and
                      D. Fleischmann$^*$ and A. Rühle$^*$ and N. H. Nicolay$^*$
                      and A. Fabian and A. Löser and S. Heß and B. Tamaskovics
                      and M. Vinsensia and M. Hecht},
      collaboration = {Y. D. Group},
      title        = {{D}ose-escalated re-irradiation improves outcome in locally
                      recurrent head and neck cancer - {R}esults of a large
                      multicenter analysis.},
      journal      = {Radiotherapy and oncology},
      volume       = {181},
      issn         = {0167-8140},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2022-02511},
      pages        = {109380},
      year         = {2023},
      note         = {181, 109380},
      abstract     = {To determine efficacy and prognostic parameters of
                      definitive re-irradiation of locoregionally recurrent
                      squamous cell carcinoma of the head and neck
                      (HNSCC).Patients with locoregionally recurrent or second
                      primary HNSCC undergoing re-irradiation with modern
                      radiotherapy technique were eligible for this multicentric
                      retrospective analysis. Main endpoints were overall survival
                      (OS), progression-free survival (PFS) and locoregional
                      control (LC). Univariate analyses were performed using the
                      Kaplan Meier Method (log-rank). For multivariable analysis,
                      Cox regression was used.A total of 253 patients treated
                      between 2009 and 2020 at 16 university hospitals in Germany
                      were included. The median follow up was 27.4 months (range
                      0.5 - 130). The median OS and PFS were 13.2 (CI: 10.7 -
                      15.7) months and 7.9 (CI: 6.7 - 9.1) months, respectively,
                      corresponding to two-year OS and PFS rates of $29\%$ and
                      $19\%.$ Rates of locoregional progression and
                      'in-field-failure' were $62\%$ and $51\%$ after two years.
                      Multivariable Cox regression analysis identified good ECOG
                      performance status and high radiation dose as independent
                      prognostic parameters for OS. Doses above 50 Gy (EQD2)
                      achieved longer median OS of 17.8 months (vs. 11.7 months,
                      p<0.01) and longer PFS of 9.6 months (vs. 6.8 months,
                      p<0.01). In addition, there was a trend for worse survival
                      in patients with tracheostomy (multivariable, p=0.061).
                      Concomitant systemic therapy did not significantly impact
                      PFS or OS.Re-irradiation of locally recurrent or second
                      primary HNSCC is efficient, especially if doses above 50Gy
                      (EQD2) are delivered. ECOG performance score was the
                      strongest prognostic parameter for OS and PFS.},
      keywords     = {HNSCC (Other) / Re-Radiochemotherapy (Other) /
                      Re-irradiation (Other) / head and neck cancer (Other) /
                      recurrent (Other) / reirradiation (Other)},
      cin          = {MU01 / E055},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331 / I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36273736},
      doi          = {10.1016/j.radonc.2022.10.007},
      url          = {https://inrepo02.dkfz.de/record/182237},
}