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Feasibility of Re-irradiation using carbon ions for recurrent head and neck malignancies after carbon-ion radiotherapy
- Source :
- Radiotherapy and Oncology. 136:148-153
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background and purpose Locoregional recurrence after carbon-ion radiotherapy (CIRT) for primary head and neck malignancies, such as malignant mucosal melanoma, adenoid cystic carcinoma, and sarcoma, occurs occasionally. However, the treatment options are limited. We report on the toxicity and efficacy of re-irradiation using carbon ions for recurrent head and neck malignancies after CIRT. Materials and methods Data of 48 patients with recurrent head and neck malignancies treated with re-irradiation with CIRT at our institution (2007–2016) were retrospectively analyzed. Twenty-one patients (43.8%) had malignant mucosal melanoma, 17 (35.4%) had adenoid cystic carcinoma, six (12.5%) had bone and soft tissue sarcomas, and four patients (8.3%) had other disease types. Tumor recurrences at re-irradiation were located in the paranasal cavity (n = 18, 37.5%), nasal cavity (n = 9, 18.8%), nasopharynx (n = 4, 8.3%), orbit (n = 3, 6.3%), cavernous sinus (n = 3, 6.3%), and at other sites (n = 11, 22.9%). The median dose of initial CIRT and that at re-irradiation were 57.6 Gy and 54.0 Gy (relative biological effectiveness [RBE]), respectively. None of the patients received concurrent chemotherapy. Results The median follow-up period after re-irradiation was 27.1 months. Five patients (10.4%) developed Grade 3 acute toxicities and 18 (37.5%) developed Grade ≥3 late toxicities, including Grade 5 central nervous system necrosis in one patient. The 2-year local control, locoregional control, progression-free survival, and overall survival rates were 40.5, 33.5%, 29.4%, and 59.6%, respectively. Conclusion Re-irradiation using carbon ions may be a reasonable treatment option with tolerable toxicity for patients with recurrent head and neck malignancies after CIRT.
- Subjects :
- Adult
Male
Re-Irradiation
Nasal cavity
medicine.medical_specialty
Adenoid cystic carcinoma
medicine.medical_treatment
Heavy Ion Radiotherapy
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Mucosal melanoma
Soft tissue
Radiotherapy Dosage
Hematology
Middle Aged
medicine.disease
Radiation therapy
medicine.anatomical_structure
Oncology
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Cavernous sinus
Feasibility Studies
Female
Sarcoma
Radiology
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 01678140
- Volume :
- 136
- Database :
- OpenAIRE
- Journal :
- Radiotherapy and Oncology
- Accession number :
- edsair.doi.dedup.....1492907a910cfa17196bfaedf75f5521