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Stereotactic reirradiation in the treatment of head and neck cancers: A retrospective study on the long-term experience of the Oscar Lambret Center.
- Source :
-
Radiotherapy & Oncology . Jan2024, Vol. 190, pN.PAG-N.PAG. 1p. - Publication Year :
- 2024
-
Abstract
- • Very long-term analysis (median follow-up 106 months). • First analysis of a large homogenous cohort treated by 36 Gy in 6 fractions. • Evidence of late toxicities probably underestimated. • Results suggesting cessation of concomitant cetuximab without further evidence. Stereotactic radiotherapy potentially treats unresectable recurrences of previously irradiated head and neck (H&N) cancer. This study aimed to assess its efficacy and safety and evaluate prognostic factors. We conducted a large retrospective series that included 110 patients who had undergone 36-Gy, six-fraction stereotactic reirradiation (CyberKnife®) for recurrent/secondary H&N cancer between 2007 and 2020 at the Oscar Lambret Center. Patient characteristics and toxicities were assessed. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Median follow-up time was 106.3 months. The 2-year OS rate was 43.8 % (95 % confidence interval, 95 % CI, 34.3–52.9) and the median survival was 20.8 months (95 % CI, 16.5–26.3). The cumulative 2-year local-recurrence, regional-recurrence, and distant-metastasis rates were 52.2 % (95 % CI, 42.4–61.1 %), 12.8 % (95 % CI, 7.4–19.8 %), and 11 % (95 % CI, 6.0–17.6 %), respectively. 73 patients received concomitant cetuximab, and it was not significantly beneficial (HR = 1.34; 95 % CI, 0.80–2.26; p = 0.26). The cumulative incidences of grade ≥ 2 late toxicity was 42 % (CI95%: 33–51) at 24 months. Two grade 4 bleedings and no treatment-related deaths were reported. In a large retrospective series of SBRT reirradiation for recurrent or second primary H&N cancers, we observed a median OS of 20.8 months, with a cumulative incidence of grade ≥ 2 late toxicity of 42 % at 24 months. Such a treatment is feasible. However, local recurrence rates remain non-negligible, warranting further research. Radiosensitizer use is currently under study. Therefore, establishing a balance between therapeutic modifications and toxicity is essential. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01678140
- Volume :
- 190
- Database :
- Academic Search Index
- Journal :
- Radiotherapy & Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 175498620
- Full Text :
- https://doi.org/10.1016/j.radonc.2023.110029