Definitive re-irradiation using intensity-modulated radiation therapy in cancers of the head and neck, focusing on rare tumors

Abstract

Purpose: To analyze the outcomes following re-irradiation for local recurrence of rare head and neck tumors.

Material and methods: We retrospectively analyzed 11 patients who had received intensity-modulated radiation therapy (IMRT) for recurrent tumors in the head and neck except for laryngopharynx.

Results: Primary tumor sites included the maxillary sinus, nasal cavity, and external ear canal in six, three, and two patients, respectively. The median follow-up times were 13 (range, 3–54) months. The median survival time was 17 months with 1- and 2-year survival rates of 63.64 and 39.77%, respectively. Among 11 patients, five experienced local failure in the follow-up period. The 1- and 2-year local control rates were 58 and 47%, respectively. Patients who had received a radiation dose of ≥3 Gy per fraction showed significantly better local control than those receiving less (p = .0419). One patient experienced Grade 3 facial pain as acute toxicity. Late toxicities included radiographic findings of partial central nervous system necrosis in three patients and Grade 3 osteonecrosis and Grade 3 facial nerve disorder in one patient.

Conclusions: Re-irradiation of rare head and neck tumors using IMRT for loco-regional recurrence may be an acceptable treatment option.

Chinese abstract

目的：分析通过再次照射来检查罕见头颈部肿瘤局部复发的结果。

材料和方法：我们回顾性分析了11例接受调强放疗（IMRT）治疗除喉咽外的头颈部复发肿瘤的患者, 。

结果：6例、3例和2例患者的原发肿瘤部位分别是上颌窦、鼻腔和外耳道。中位随访时间为13个月（范围3-54）。中位生存时间为17个月；1年和2年生存率分别为63.64％和39.77％。在11名患者中, 5名在随访期间出现局部失败。 1年和2年的局部控制率分别为58％和47％。接受每次≥3Gy放射剂量的患者比接受低剂量的患者表示出更好的局部控制（p = 0.0419）。一名患者经历了急性毒性的3级面部疼痛。晚期毒性包括3名患者的部分中枢神经系统坏死的放射显影结果和1名患者的3级骨坏死和3级面部神经障碍。

结论：使用IMRT再次照射来治疗局部复发的罕见头颈部肿瘤可能是一种可接受的治疗选择。

Keywords:

• Intensity-modulated radiation therapy
• re-irradiation
• paranasal sinus carcinoma
• maxillary sinus carcinoma
• radiotherapy
• head and neck
• stereotactic body radiation therapy

Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Grant-in-Aid for Young Scientists (B) Grant No. 17K16493.