RSNA 2003 

Abstract Archives of the RSNA, 2003


C17-367

The Effect of Re-irradiation of Inoperable Local Tumor Recurrences in Preirradiated Areas of the Head and Neck

Scientific Papers

Presented on December 1, 2003
Presented as part of C17: Radiation Oncology and Radiobiology (Head and Neck Cancer)

Participants

Ulrich Schaefer MD, PRESENTER: Nothing to Disclose

Abstract:Purpose/Objective: Inoperable local tumor recurrences in pre-irradiated areas of the head and neck pose a difficult therapeutic problem. The effect of re-irradiation was analysed in a prospective phase II study. Materials/Methods: Since 1995 recurrent head and neck carcinomas are uniformly treated at our department. The protocol consists in several courses of a combined radiochemotherapy: Each course is constituted by one week of treatment (2 Gy and 1.5 g HU / 300 mg/m2 5-FU i.v. bolus per day), followed by a one week break. Courses are repeated until a cumulative total dose of 120 Gy is reached. Toxicities are prospectively recorded using a standardized RTOG-compatible form. Results: Until 7/2002, 55 patients have been treated. The pretherapeutic performance status (WHO) was in 20 % grade 0, in 61 % grade 1 and in 19 % grade 2. Radiation dose usually amounted to 40 or 50 Gy with a median PTV volume of 310 cm3. In 8 cases, treatment was discontinued because of worsened general condition or disease progression. Acute toxicities grade 2 (3) were found for dermatitis in 36% (3%), mucositis in 35% (4%), and hematologic in 27% (6%). 3 months after treatment, 40% of patients reached a remission, which persisted for a median duration of 6 months. The median survival time amounted to 10 months, 4 patients currently have a survival time of > 36 months. Performance status, radiation dose, disease-free interval and pretreatment hemoglobin had a significant influence on survival. Late toxicities grade 1-2 (3) were observed in 22% (18%) of patients (mostly lymphedema and fibrosis). Conclusions: The reported protocol presents a treatment option with moderate toxicity, improved tumor regression and median survival than chemotherapy alone and, in individual cases, possible long term survival.

Cite This Abstract

Schaefer MD, U, The Effect of Re-irradiation of Inoperable Local Tumor Recurrences in Preirradiated Areas of the Head and Neck.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3240327.html