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<p>Recurrent or second primary head and neck cancers (HNC) in previously irradiated regions remain challenging to treat. With evolving radiotherapy (RT) techniques like VMAT, re-irradiation (Re-RT) offers a potential for disease control in select patients. This retrospective study analyzed 63 patients who underwent Re-RT for recurrent or second primary HNC from 2019 to 2022 at a tertiary Indian cancer center. Patients with no distant metastases and overlapping RT fields were included. All were treated with VMAT without concurrent chemotherapy. Outcomes assessed included progression-free survival (PFS), overall survival (OS), and prognostic factors. Median OS was 22.7 months, with 1-, 3-, and 5-year OS rates of 69%, 36.9%, and 21.7%, respectively. Median PFS was 8 months. Younger age (&lt; 50 years, <i>p</i> = 0.01) and longer disease-free interval (DFI ≥ 5 years, <i>p</i> = 0.001) significantly correlated with better PFS. Recurrence type, gross tumor volume, Re-RT dose, and stage were not statistically significant predictors of PFS. Re-irradiation using modern techniques can offer meaningful survival in select HNC patients, especially those younger and with longer DFI. Personalized treatment selection remains key in optimizing outcomes.</p>

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Real World Outcomes of Re-Irradiation in Head and Neck Cancer: Experience from a Tertiary Cancer Center

  • 期刊论文

  • 发表日期：

    2025年7月30日

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  • Tapashi Das,
  • Jyotiman Nath,
  • Abhinandan Das,
  • Yanpothung Yanthan,
  • Saswati Datta,
  • Kaberi Kakati,
  • Rahul Thakuria

摘要

Recurrent or second primary head and neck cancers (HNC) in previously irradiated regions remain challenging to treat. With evolving radiotherapy (RT) techniques like VMAT, re-irradiation (Re-RT) offers a potential for disease control in select patients. This retrospective study analyzed 63 patients who underwent Re-RT for recurrent or second primary HNC from 2019 to 2022 at a tertiary Indian cancer center. Patients with no distant metastases and overlapping RT fields were included. All were treated with VMAT without concurrent chemotherapy. Outcomes assessed included progression-free survival (PFS), overall survival (OS), and prognostic factors. Median OS was 22.7 months, with 1-, 3-, and 5-year OS rates of 69%, 36.9%, and 21.7%, respectively. Median PFS was 8 months. Younger age (< 50 years, p = 0.01) and longer disease-free interval (DFI ≥ 5 years, p = 0.001) significantly correlated with better PFS. Recurrence type, gross tumor volume, Re-RT dose, and stage were not statistically significant predictors of PFS. Re-irradiation using modern techniques can offer meaningful survival in select HNC patients, especially those younger and with longer DFI. Personalized treatment selection remains key in optimizing outcomes.