Reirradiation for recurrent head and neck cancers using charged particle or photon radiotherapy.

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Reirradiation for recurrent head and neck cancers using charged particle or photon radiotherapy.

Strahlenther Onkol. 2017 Apr 19;:

Authors: Yamazaki H, Demizu Y, Okimoto T, Ogita M, Himei K, Nakamura S, Suzuki G, Yoshida K, Kotsuma T, Yoshioka Y, Oh R

Abstract
OBJECTIVE: To examine the outcomes of reirradiation for recurrent head and neck cancers using different modalities.
METHODS: This retrospective study included 26 patients who received charged particle radiotherapy (CP) and 150 who received photon radiotherapy (117 CyberKnife radiotherapy [CK] and 36 intensity-modulated radiotherapy [IMRT]). Inverse probability of treatment weighting (IPTW) involving propensity scores was used to reduce background selection bias.
RESULTS: Higher prescribed doses were used in CP than photon radiotherapy. The 1‑year overall survival (OS) rates were 67.9% for CP and 54.1% for photon radiotherapy (p = 0.15; 55% for CK and 51% for IMRT). In multivariate Cox regression, the significant prognostic factors for better survival were nasopharyngeal cancer, higher prescribed dose, and lower tumor volume. IPTW showed a statistically significant difference between CP and photon radiotherapy (p = 0.04). The local control rates for patients treated with CP and photon radiotherapy at 1 year were 66.9% (range 46.3-87.5%) and 67.1% (range 58.3-75.9%), respectively. A total of 48 patients (27%) experienced toxicity grade ≥3 (24% in the photon radiotherapy group and 46% in the CP group), including 17 patients with grade 5 toxicity. Multivariate analysis revealed that younger age and a larger planning target volume (PTV) were significant risk factors for grade 3 or worse toxicity.
CONCLUSION: CP provided superior survival outcome compared to photon radiotherapy. Tumor volume, primary site (nasopharyngeal), and prescribed dose were identified as survival factors. Younger patients with a larger PTV experienced toxicity grade ≥3.

PMID: 28424840 [PubMed - as supplied by publisher]

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