Roesch, Johannes and Oertel, Michael and Wegen, Simone and Trommer, Maike and Schleifenbaum, Julia and Hering, Dominik and Maeurer, Matthias and Knippen, Stefan and Dobiasch, Sophie and Waltenberger, Maria and von der Gruen, Jens and Medenwald, Daniel and Suess, Christoph and Hoeck, Michael and Kaesmann, Lukas and Fleischmann, Daniel F. and Ruehle, Alexander and Nicolay, Nils H. and Fabianq, Alexander and Loeser, Anastassia and Hess, Sebastian and Tamaskovics, Balint and Vinsensia, Maria and Hecht, Markus (2023) Dose-escalated re-irradiation improves outcome in locally recurrent head and neck cancer-Results of a large multicenter analysis. RADIOTHERAPY AND ONCOLOGY, 181: 109380. ISSN 0167-8140, 1879-0887
Full text not available from this repository. (Request a copy)Abstract
To determine efficacy and prognostic parameters of definitive re-irradiation of locoregionally recurrent squamous cell carcinoma of the head and neck (HNSCC).Materials and methods: 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 analy-sis, Cox regression was used.Results: 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.Conclusion: Re-irradiation of locally recurrent or second primary HNSCC is efficient, especially if doses above 50 Gy (EQD2) are delivered. ECOG performance score was the strongest prognostic parameter for OS and PFS.(c) 2022 Elsevier B.V. All rights reserved. Radiotherapy and Oncology xxx (2023) xxx-xxx
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SQUAMOUS-CELL CARCINOMA; 2ND PRIMARY HEAD; OPEN-LABEL; CHEMOTHERAPY; RADIOTHERAPY; CETUXIMAB; IMRT; CHEMORADIOTHERAPY; TRIAL; CHEMORADIATION; Re-irradiation; Reirradiation; Re-Radiochemotherapy; HNSCC; Head and neck cancer; Recurrent |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Strahlentherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Jan 2024 10:25 |
| Last Modified: | 30 Jan 2024 10:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60867 |
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