Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 30, Issue 3, Pages 281-288Publisher
WILEY
DOI: 10.1002/hed.20697
Keywords
recurrent head and neck; reirradiation; chemoradiation; squamous cell carcinoma; late effects
Categories
Funding
- NCI NIH HHS [CA-21661] Funding Source: Medline
Ask authors/readers for more resources
Background. Our objectives were to determine the incidence of acute and late toxicities and to estimate the 2-year overall survival for patients treated with reirradiation and chemotherapy for unresectable squamous cell carcinoma of the head and neck (SCCHN). Methods. Patients with recurrent squamous cell carcinoma or a second primary arising in a previously irradiated field were eligible. Four weekly cycles of 5-fluorouracil 300 mg/m(2) IV bolus and hydroxyurea 1.5 g by mouth were used with 60 Gy at 1.5 Gy twice-daily fractions. Toxicity was scored according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria. Results. Seventy-nine of the 86 patients enrolled were analyzable. The worst acute toxicity was grade 4 in 17.7% and grade 5 in 7.6%. Grade 3 and 4 late toxicities were found in 19.4% and 3.0%, respectively. The estimated cumulative incidence of grade 3 to 4 late effects occurring at > 1 year was 9.4% (95% confidence interval [Cl]: 0, 197) at 2 and 5 years. The 2- and 5-year cumulative incidence for grade 4 toxicity was 31% (95% Cl: 0, 9.3). The estimated 2- and 5-year survival rates were 15.2% (95% Cl: 7.3, 23.1) and 3.8% (95% Cl: 0.8, 8.0), respectively. Patients who entered the study at >1 year from initial radiotherapy (RT) had better survival than did those who were < 1 year from prior RT (median survival, 9.8 months vs 5.8 months; p =.036). No correlation was detected between dose received and overall survival. Three patients were alive at 5 years. Conclusion. This is the first prospective multi-institutional trial testing reirradiation plus chemotherapy for recurrent or second SCCHN. The approach is feasible with acceptable acute and late effects. The results serve as a benchmark for ongoing RTOG trials. (c) 2007 Wiley Periodicals, Inc.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available