Salvage re-irradiation for recurrent XXXX .

@entity1 @entity135 @entity137 @entity5 @entity902
PURPOSE: To present a retrospective review of treatment outcomes for recurrent @entity135 @entity1 treated with re-irradiation (re-RT) at a single medical center. METHODS AND MATERIALS: From July 1996-September 2005, 105 @entity1 with recurrent @entity135 underwent re-RT at our institution. Sites included were: the neck (n = 21), nasopharynx (n = 21), paranasal sinus (n = 18), oropharynx (n = 16), oral cavity (n = 9), larynx (n = 10), parotid (n = 6), and hypopharynx (n = 4). The median prior RT dose was 62 Gy. Seventy-five @entity1 received chemotherapy with their re-RT ( @entity902 -based in the majority of cases). The median re-RT dose was 59.4 Gy. In 74 (70%), re-RT utilized intensity-modulated radiation therapy (IMRT). RESULTS: With a median follow-up of 35 months, 18 @entity1 were alive with no evidence of disease. The 2-year loco-regional progression-free survival (LRPFS) and overall survival rates were 42% and 37%, respectively. @entity1 who underwent IMRT, compared to those who did not, had a better 2-year LRPF (52% vs. 20%, p < 0.001). On multivariate analysis, non-nasopharynx and non-IMRT were associated with an increased risk of loco-regional (LR) failure. @entity1 with LR progression-free disease had better 2-year overall survival vs. those with LR failure (56% vs. 21%, p < 0.001). Acute and late Grade 3-4 @entity137 were reported in 23% and 15% of @entity1 . Severe Grade 3-4 late complications were observed in 12 @entity1 , with a median time to development of 6 months after re-RT. CONCLUSIONS: Based on our data, achieving LR control is crucial for improved overall survival in this @entity1 population. The use of IMRT predicted better LR @entity5 control. Future aggressive efforts in maximizing @entity5 control in the recurrent setting, including dose escalation with IMRT and improved chemotherapy, are warranted.
