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Re-irradiation in head and neck cancers: an Indian tertiary cancer centre experience

Published online by Cambridge University Press:  15 October 2014

S Mallick ,
A K Gandhi ,
N P Joshi ,
S Pandit ,
S Bhasker ,
A Sharma ,
A Thakar  and
B K Mohanti
S Mallick
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
A K Gandhi*
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
N P Joshi
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
S Pandit
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
S Bhasker
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
A Sharma
Affiliation:
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
A Thakar
Affiliation:
Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, Delhi, India
B K Mohanti
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
*
Address for correspondence: Dr Ajeet Kumar Gandhi, Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India Fax: +91-11-26589821 E-mail: ajeetgandhi23@gmail.com
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Abstract

Objective:

To explore the treatment outcomes of patients treated with re-irradiation for recurrent or second primary head and neck cancer.

Method:

An analysis was performed of 79 head and neck cancer patients who underwent re-irradiation for second primaries or recurrent disease from January 1999 to December 2011.

Results:

Median time from previous radiation to re-irradiation for second primary or recurrence was 53.6 months (range, 2.7–454.7 months). Median age at diagnosis of first primary was 54 years. Median re-irradiation dose was 45 Gy (range, 45–60 Gy). Acute grade 3 or worse toxicity was seen in 30 per cent of patients. Median progression-free survival for recurrent disease was 15.0 months (95 per cent confidence interval, 8.33–21.66). The following factors had a statistically significant, positive impact on progression-free survival: patient age of less than 50 years (median progression-free survival was 29.43, vs 13.9 months for those aged 50 years or older; p = 0.004) and disease-free interval of 2 years or more (median progression-free survival was 51.66, vs 13.9 months for those with less than 2 years disease-free interval).

Conclusion:

Re-irradiation of second primaries or recurrences of head and neck cancers with moderate radiation doses yields acceptable progression-free survival and morbidity rates.

Keywords

Head And Neck NeoplasmsRadiotherapyRetreatment
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 11 , November 2014 , pp. 996 - 1002
Copyright
Copyright © JLO (1984) Limited 2014 

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