Reirradiation of recurrent head and neck cancers

Recurrent cancer in head and neck is no uncommon clinical problem. Average cure rate of these patients has been reported to vary between 30-40% and most failures are due to locoregional relapses. After a previous full course of radiation surgery is the salvage modality of choice; however, if surgery was not feasible for whatever reason, reirradiation has been offered to some patients. To establish the role of reirradiation in head and neck cancer, a 13-year experience with patients reirradiated in DDHHC was analyzed. Reirradiation was performed 1970-1980 by means of external beam radiation therapy (ERT series, n=55) and 1985-1988 by external radiation combined with interstitial radiation therapy (IRT±ERT series; n=18).A minimum follow-up of 3 years was allowed for. Improvement in local control was observed (50 vs 29%) for IRT±ERT series and ERT series respectively. Improvement in local control was not reflected in a survival benefit; i.e. actuarial overall survival of 20% at 5 years was observed in both series. No treatment-related deaths occurred. However, for the patients that were controlled at the reirradiated site, 28% (4/16 of the ERT series and 3/9 of the IRT±ERT series) experienced severe side effects. (author). 15 refs.; 6 figs.; 10 tabs