Curative high-dose reirradiation for patients with recurrent head and neck squamous cell carcinoma using IMRT or proton therapy: Outcomes and analysis of patterns of failure

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Beddok, Arnaud | Saint-Martin, Caroline | Krhili, Samar | Eddine, Catherine Ala | Champion, Laurence | Chilles, Anne | Goudjil, Farid | Zefkili, Sofia | Amessis, Malika | Peurien, Dominique | Choussy, Olivier | Le Tourneau, Christophe | Dendale, Remi | Buvat, Irene | Créhange, Gilles | Calugaru, Valentin

Edité par CCSD ; Wiley -

International audience. Purpose: To analyze outcomes of patients treated with curative reirradiation (reRT), with intensity-modulated radiation therapy (IMRT) or proton therapy (PT) for recurrent head and neck squamous cell carcinoma (HNSCC). Materials: Among the 55 patients reirradiated for head and neck cancer from 30/08/2012 to 08/04/2019, 23 had HNSCC and received IMRT (52.2%) or PT (47.8%) at a median maximum dose to the CTV of 66 Gy. Results: After a median follow-up of 41.3 months, 18 patients developed a locoregional recurrence (LR), of which eight (44.4%) occurred within the previously reirradiated volume. Two-year locoregional failure-free survival and overall survival were 18.3%[95%CI:7.1%-47.1%] and 42.5%[95%CI:26.2%-69.1%], respectively. Disease-free survival was significantly longer in the PT group (p = 0.031). Main late grade ≥2 toxicities were dysphagia and trismus. Conclusion: Curative reRT in HNSCC is possible for selected cases, but the LR rate in the irradiated field and the risk of toxicity grade ≥2 remain high.

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