Re-irradiation is becoming an established treatment option for recurrent or second primary head and neck cancer(HNC). However, acute and long-term RT-related toxicities could dramatically impact patients' quality of life. Due to the sparse literature regarding HNC re-irradiation, data on tolerance doses for various organs at risk (OARs) are scarce. Our aim was to systematically review the clinical literature regarding HNC re-irradiation, focusing on treatment toxicity, OARs tolerance, and dose limit recommendations. Thirty-nine studies (three randomized, five prospective, 31 retrospective) including 3766 patients were selected. The median interval time between the first course and re-irradiation was 28 months (range, 6-90). In 1043 (27.6%) patients, post-operative re-irradiation was performed. Re-irradiation doses ranged from 30 Gy in 3 fractions using stereotactic technique to 72 Gy in conventional fractionation using intensity-modulated radiotherapy. Pooled acute and late toxicityrates >= G3 were 32% and 29.3%, respectively. The most common grade 3-4 toxic effects were radionecrosis, dysphagia requiring feeding tube placement and trismus. In 156 (4.1%) patients, carotid blowout was reported. Recommendations for limiting toxicity included the time interval between radiation treatments, the fractionation schedules, and the re-irradiation treatment volumes. Cumulative dose limit suggestions were found and discussed for the carotid arteries, temporal lobes, and mandible.

Organs at risk's tolerance and dose limits for head and neck cancer re-irradiation: A literature review / Dionisi, F.; Fiorica, F.; D'Angelo, E.; Maddalo, M.; Giacomelli, I.; Tornari, E.; Rosca, A.; Vigo, F.; Romanello, D.; Cianchetti, M.; Tommasino, F.; Massaccesi, M.; Orlandi, E.. - In: ORAL ONCOLOGY. - ISSN 1368-8375. - 98:(2019), pp. 35-47. [10.1016/j.oraloncology.2019.08.017]

Organs at risk's tolerance and dose limits for head and neck cancer re-irradiation: A literature review

Tommasino F.;
2019-01-01

Abstract

Re-irradiation is becoming an established treatment option for recurrent or second primary head and neck cancer(HNC). However, acute and long-term RT-related toxicities could dramatically impact patients' quality of life. Due to the sparse literature regarding HNC re-irradiation, data on tolerance doses for various organs at risk (OARs) are scarce. Our aim was to systematically review the clinical literature regarding HNC re-irradiation, focusing on treatment toxicity, OARs tolerance, and dose limit recommendations. Thirty-nine studies (three randomized, five prospective, 31 retrospective) including 3766 patients were selected. The median interval time between the first course and re-irradiation was 28 months (range, 6-90). In 1043 (27.6%) patients, post-operative re-irradiation was performed. Re-irradiation doses ranged from 30 Gy in 3 fractions using stereotactic technique to 72 Gy in conventional fractionation using intensity-modulated radiotherapy. Pooled acute and late toxicityrates >= G3 were 32% and 29.3%, respectively. The most common grade 3-4 toxic effects were radionecrosis, dysphagia requiring feeding tube placement and trismus. In 156 (4.1%) patients, carotid blowout was reported. Recommendations for limiting toxicity included the time interval between radiation treatments, the fractionation schedules, and the re-irradiation treatment volumes. Cumulative dose limit suggestions were found and discussed for the carotid arteries, temporal lobes, and mandible.
2019
Dionisi, F.; Fiorica, F.; D'Angelo, E.; Maddalo, M.; Giacomelli, I.; Tornari, E.; Rosca, A.; Vigo, F.; Romanello, D.; Cianchetti, M.; Tommasino, F.; Massaccesi, M.; Orlandi, E.
Organs at risk's tolerance and dose limits for head and neck cancer re-irradiation: A literature review / Dionisi, F.; Fiorica, F.; D'Angelo, E.; Maddalo, M.; Giacomelli, I.; Tornari, E.; Rosca, A.; Vigo, F.; Romanello, D.; Cianchetti, M.; Tommasino, F.; Massaccesi, M.; Orlandi, E.. - In: ORAL ONCOLOGY. - ISSN 1368-8375. - 98:(2019), pp. 35-47. [10.1016/j.oraloncology.2019.08.017]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11572/245826
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