View in EDS

Reirradiation of Head and Neck Cancers With Intensity Modulated Radiation Therapy: Outcomes and Analyses.

Saved in:
Bibliographic Details
Title: Reirradiation of Head and Neck Cancers With Intensity Modulated Radiation Therapy: Outcomes and Analyses.
Authors: Takiar, Vinita1, Garden, Adam S.2, Ma, Dominic2, Morrison, William H.2, Edson, Mark2, Zafereo, Mark E.3, Gunn, Gary B.2, Fuller, Clifton D.2, Beadle, Beth2, Frank, Steven J.2, Jr.William, William N.4, Kies, Merrill4, El-Naggar, Adel K.5, Weber, Randal3, Rosenthal, David I.2, Phan, Jack2 jphan@mdanderson.org, William, William N Jr4
Source: International Journal of Radiation Oncology, Biology, Physics. Jul2016, Vol. 95 Issue 4, p1117-1131. 15p.
Subjects: Head & neck cancer patients, Head & neck cancer treatment, Intensity modulated radiotherapy, Cancer radiotherapy, Cancer chemotherapy, Head tumors, Neck tumors, Prognosis, Radiotherapy, Squamous cell carcinoma, Retrospective studies, Salvage therapy
Abstract: Purpose: To review our 15-year institutional experience using intensity modulated radiation therapy (IMRT) to reirradiate patients with head and neck squamous cell carcinomas (HNSCC) and identify predictors of outcomes and toxicity.Methods and Materials: We retrospectively reviewed the records of 227 patients who received head and neck reirradiation using IMRT from 1999 to 2014. Patients treated with noncurative intent were excluded. Radiation-related acute and late toxicities were recorded. Prognostic variables included performance status, disease site, disease-free interval, chemotherapy, and RT dose and volume. Correlative analyses were performed separately for surgery and nonsurgery patients.Results: Two hundred six patients (91%) were retreated with curative intent, and 173 had HNSCC histology; 104 (50%) underwent salvage resection, and 135 (66%) received chemotherapy. Median follow-up after reirradiation was 24.7 months. Clinical outcomes were worse for HNSCC patients, with 5-year locoregional control, progression-free survival, and overall survival rates of 53%, 22%, and 32%, respectively, compared with 74%, 59%, and 79%, respectively, for non-HNSCC patients. On multivariate analysis, concurrent chemotherapy and retreatment site were associated with tumor control, whereas performance status was associated with survival. Favorable prognostic factors specific to surgery patients were neck retreatment and lack of extracapsular extension, whereas for nonsurgery patients, these were a nasopharynx subsite and complete response to induction chemotherapy. Actuarial rates of grade ≥3 toxicity were 32% at 2 years and 48% at 5 years, with dysphagia or odynophagia being most common. Increased grade ≥3 toxicity was associated with retreatment volume >50 cm(3) and concurrent chemotherapy.Conclusions: Reirradiation with IMRT either definitively or after salvage surgery can produce promising local control and survival in selected patients with head and neck cancers. Treatment-related toxicity remains significant. Prognostic factors are emerging to guide multidisciplinary treatment approaches and clinical trial design. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
FullText Text:
  Availability: 0
Header DbId: egs
DbLabel: Engineering Source
An: 116378324
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Reirradiation of Head and Neck Cancers With Intensity Modulated Radiation Therapy: Outcomes and Analyses.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Takiar%2C+Vinita%22">Takiar, Vinita</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Garden%2C+Adam+S%2E%22">Garden, Adam S.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Ma%2C+Dominic%22">Ma, Dominic</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Morrison%2C+William+H%2E%22">Morrison, William H.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Edson%2C+Mark%22">Edson, Mark</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Zafereo%2C+Mark+E%2E%22">Zafereo, Mark E.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Gunn%2C+Gary+B%2E%22">Gunn, Gary B.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Fuller%2C+Clifton+D%2E%22">Fuller, Clifton D.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Beadle%2C+Beth%22">Beadle, Beth</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Frank%2C+Steven+J%2E%22">Frank, Steven J.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Jr%2EWilliam%2C+William+N%2E%22">Jr.William, William N.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Kies%2C+Merrill%22">Kies, Merrill</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22El-Naggar%2C+Adel+K%2E%22">El-Naggar, Adel K.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Weber%2C+Randal%22">Weber, Randal</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Rosenthal%2C+David+I%2E%22">Rosenthal, David I.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Phan%2C+Jack%22">Phan, Jack</searchLink><relatesTo>2</relatesTo><i> jphan@mdanderson.org</i><br /><searchLink fieldCode="AR" term="%22William%2C+William+N+Jr%22">William, William N Jr</searchLink><relatesTo>4</relatesTo>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Jul2016, Vol. 95 Issue 4, p1117-1131. 15p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Head+%26+neck+cancer+patients%22">Head & neck cancer patients</searchLink><br /><searchLink fieldCode="DE" term="%22Head+%26+neck+cancer+treatment%22">Head & neck cancer treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Intensity+modulated+radiotherapy%22">Intensity modulated radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+radiotherapy%22">Cancer radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+chemotherapy%22">Cancer chemotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Head+tumors%22">Head tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Neck+tumors%22">Neck tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Prognosis%22">Prognosis</searchLink><br /><searchLink fieldCode="DE" term="%22Radiotherapy%22">Radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Squamous+cell+carcinoma%22">Squamous cell carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Salvage+therapy%22">Salvage therapy</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Purpose: </bold>To review our 15-year institutional experience using intensity modulated radiation therapy (IMRT) to reirradiate patients with head and neck squamous cell carcinomas (HNSCC) and identify predictors of outcomes and toxicity.<bold>Methods and Materials: </bold>We retrospectively reviewed the records of 227 patients who received head and neck reirradiation using IMRT from 1999 to 2014. Patients treated with noncurative intent were excluded. Radiation-related acute and late toxicities were recorded. Prognostic variables included performance status, disease site, disease-free interval, chemotherapy, and RT dose and volume. Correlative analyses were performed separately for surgery and nonsurgery patients.<bold>Results: </bold>Two hundred six patients (91%) were retreated with curative intent, and 173 had HNSCC histology; 104 (50%) underwent salvage resection, and 135 (66%) received chemotherapy. Median follow-up after reirradiation was 24.7 months. Clinical outcomes were worse for HNSCC patients, with 5-year locoregional control, progression-free survival, and overall survival rates of 53%, 22%, and 32%, respectively, compared with 74%, 59%, and 79%, respectively, for non-HNSCC patients. On multivariate analysis, concurrent chemotherapy and retreatment site were associated with tumor control, whereas performance status was associated with survival. Favorable prognostic factors specific to surgery patients were neck retreatment and lack of extracapsular extension, whereas for nonsurgery patients, these were a nasopharynx subsite and complete response to induction chemotherapy. Actuarial rates of grade ≥3 toxicity were 32% at 2 years and 48% at 5 years, with dysphagia or odynophagia being most common. Increased grade ≥3 toxicity was associated with retreatment volume >50 cm(3) and concurrent chemotherapy.<bold>Conclusions: </bold>Reirradiation with IMRT either definitively or after salvage surgery can produce promising local control and survival in selected patients with head and neck cancers. Treatment-related toxicity remains significant. Prognostic factors are emerging to guide multidisciplinary treatment approaches and clinical trial design. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=116378324
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.ijrobp.2016.03.015
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 1117
    Subjects:
      – SubjectFull: Head & neck cancer patients
        Type: general
      – SubjectFull: Head & neck cancer treatment
        Type: general
      – SubjectFull: Intensity modulated radiotherapy
        Type: general
      – SubjectFull: Cancer radiotherapy
        Type: general
      – SubjectFull: Cancer chemotherapy
        Type: general
      – SubjectFull: Head tumors
        Type: general
      – SubjectFull: Neck tumors
        Type: general
      – SubjectFull: Prognosis
        Type: general
      – SubjectFull: Radiotherapy
        Type: general
      – SubjectFull: Squamous cell carcinoma
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Salvage therapy
        Type: general
    Titles:
      – TitleFull: Reirradiation of Head and Neck Cancers With Intensity Modulated Radiation Therapy: Outcomes and Analyses.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Takiar, Vinita
      – PersonEntity:
          Name:
            NameFull: Garden, Adam S.
      – PersonEntity:
          Name:
            NameFull: Ma, Dominic
      – PersonEntity:
          Name:
            NameFull: Morrison, William H.
      – PersonEntity:
          Name:
            NameFull: Edson, Mark
      – PersonEntity:
          Name:
            NameFull: Zafereo, Mark E.
      – PersonEntity:
          Name:
            NameFull: Gunn, Gary B.
      – PersonEntity:
          Name:
            NameFull: Fuller, Clifton D.
      – PersonEntity:
          Name:
            NameFull: Beadle, Beth
      – PersonEntity:
          Name:
            NameFull: Frank, Steven J.
      – PersonEntity:
          Name:
            NameFull: Jr.William, William N.
      – PersonEntity:
          Name:
            NameFull: Kies, Merrill
      – PersonEntity:
          Name:
            NameFull: El-Naggar, Adel K.
      – PersonEntity:
          Name:
            NameFull: Weber, Randal
      – PersonEntity:
          Name:
            NameFull: Rosenthal, David I.
      – PersonEntity:
          Name:
            NameFull: Phan, Jack
      – PersonEntity:
          Name:
            NameFull: William, William N Jr
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 15
              M: 07
              Text: Jul2016
              Type: published
              Y: 2016
          Identifiers:
            – Type: issn-print
              Value: 03603016
          Numbering:
            – Type: volume
              Value: 95
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: International Journal of Radiation Oncology, Biology, Physics
              Type: main
ResultId 1