Reirradiation for @entity135 : delicate balance between effectiveness and XXXX .

@entity1 @entity135 @entity137 @entity138 @entity204
PURPOSE: To analyze the effectiveness and @entity137 of reirradiation (re- @entity138 ) for @entity135 . METHODS AND MATERIALS: A retrospective data analysis was performed of 58 @entity1 who underwent re- @entity138 with curative intent. Re- @entity138 was given as definitive treatment in 53% of @entity1 , whereas salvage surgery preceded reirradiation in 47%. The median cumulative @entity138 dose was 119 Gy (range, 76-140). Concurrent chemotherapy was administered with re- @entity138 (CRT) in 57% of @entity1 . Event-free survival was defined as survival without recurrence and without serious @entity137 (>= Grade 3). RESULTS: Median follow-up was 57 months (range, 9-140). Locoregional (LR) control was 50% at 2 and 5 years. The 2-year and 5-year overall survival (OS) was 42% and 34%. The following factors were associated with improved OS: postoperative re- @entity138 (vs. primary re- @entity138 ), treatment with @entity138 only (vs. CRT) and interval >3 years between previous @entity138 and re- @entity138 . For @entity1 treated with postoperative re- @entity138 and definitive re- @entity138 , the 5-year OS was 49% and 20%, respectively. @entity1 treated with CRT had a 5-year OS of 13%. Serious (late) @entity137 >= Grade 3 was observed in 20 of 47 evaluable @entity1 (43%). Three cases of treatment-related @entity204 were recorded. The 2- and 5-year serious @entity137 -free interval was 59% and 55%, respectively. Associated with increased risk of serious @entity137 were CRT and higher re- @entity138 dose. The event-free survival rates at 2 and 5 years were 34% and 31%, respectively. CONCLUSIONS: Re- @entity138 in @entity135 is associated with poor survival rates of 13-20% in @entity1 with inoperable disease treated with primary (chemo-) re- @entity138 . For this subgroup, however, no other curative options are available. Long-term disease control and survival can be achieved in @entity1 who receive re- @entity138 as an adjunct to surgical resection. The rates of serious @entity137 after re- @entity138 are high, with an incidence of approximately 45% at 5 years. Approximately 1 in 3 @entity1 survived re- @entity138 without recurrence and severe complications.
