1
|
Wotman M, Gold B, Takahashi M, Draper L, Posner M. Treatment of Recurrent and Metastatic HPV-Associated Squamous Cell Carcinoma. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00402-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
2
|
Leung HW, Lang HC, Wang SY, Leung JH, Chan AL. Cost-utility analysis of stereotactic body radiotherapy plus cetuximab in previously irradiated recurrent squamous cell carcinoma of the head and neck. Expert Rev Pharmacoecon Outcomes Res 2021; 21:489-495. [PMID: 33729079 DOI: 10.1080/14737167.2021.1890585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study aimed to estimate the cost-utility of stereotactic body radiotherapy (SBRT) plus cetuximab for patients with previously irradiated recurrent squamous cell carcinoma of the head and neck. METHODS We constructed a Markov health-state transition model to simulate costs and clinical outcomes of recurrent squamous cell carcinoma of the head and neck. Model parameters were derived from the published literature and the National Health Insurance Administration reimbursement price list. Incremental cost-effectiveness ratio and the net monetary benefit were calculated from a health payer perspective. The impact of uncertainty was modeled with one-way and probabilistic sensitivity analyses. RESULTS In the base-case, SBRT plus cetuximab compared to SBRT alone resulted in an ICER of NT$ 840,455 per QALY gained. In the one-way sensitivity analysis, the utility of progression-free state for patients treated with SBRT plus cetuximab or SBRT alone and the cost of progression-free survival for SBRT+Cet were the most sensitive parameters in the model. Probabilistic sensitivity analysis showed that the probability of cost-effectiveness at a willingness-to-pay threshold of NT$ 2,252,340 per QALY was 100% for SBRT plus cetuximab but 0% for SBRT alone. CONCLUSIONS This study showed that SBRT+Cet was cost-effective and benefited patients with previously irradiated rSCCHN.
Collapse
Affiliation(s)
- Henry Wc Leung
- Department of Radiation Oncology, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Hui-Chu Lang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Shyh-Yau Wang
- Department of Radiology, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - John Hang Leung
- Department of Obstetrics and Gynecology, Chiayi Christian Hospital, Chiayi, Taiwan
| | - Agnes Lf Chan
- Department of Pharmacy, An-Nan Hospital, China Medical University, Tainan, Taiwan
| |
Collapse
|
3
|
Svajdova M, Dubinsky P, Kazda T. Radical external beam re-irradiation in the treatment of recurrent head and neck cancer: Critical review. Head Neck 2020; 43:354-366. [PMID: 32996265 DOI: 10.1002/hed.26485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/28/2020] [Accepted: 09/21/2020] [Indexed: 11/09/2022] Open
Abstract
Management of patients with recurrent head and neck cancer remains a challenge for the surgeon as well as the treating radiation oncologist. Even in the era of modern radiotherapy, the rate of severe toxicity remains high with unsatisfactory treatment results. Intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and heavy-ion irradiation have all emerged as highly conformal and precise techniques that offer many radiobiological advantages in various clinical situations. Although re-irradiation is now widespread in clinical practice, little is known about the differences in treatment response and toxicity using diverse re-irradiation techniques. In this review, we provide a comprehensive overview of the role of radiation therapy in recurrent or second primary head and neck cancer including patient selection, therapeutic outcome, and risk using different re-irradiation techniques. Critical review of published evidence on IMRT, SBRT, and heavy-ion full-dose re-irradiation is presented including data on locoregional control, overall survival, and toxicity.
Collapse
Affiliation(s)
- Michaela Svajdova
- Clinic of Radiation and Clinical Oncology, Central Military Hospital-Teaching Hospital Ruzomberok, Slovakia.,Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Pavol Dubinsky
- Department of Radiation Oncology, East Slovakia Oncology Institute, Kosice, Slovakia.,Faculty of Health, Catholic University, Ruzomberok, Slovakia
| | - Tomas Kazda
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| |
Collapse
|
4
|
Reirradiation using stereotactic body radiotherapy in the management of recurrent or second primary head and neck cancer: A meta-analysis and systematic review. Oral Oncol 2020; 107:104757. [DOI: 10.1016/j.oraloncology.2020.104757] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
|
5
|
Ji Z, Jiang Y, Tian S, Guo F, Peng R, Xu F, Sun H, Fan J, Wang J. The Effectiveness and Prognostic Factors of CT-Guided Radioactive I-125 Seed Implantation for the Treatment of Recurrent Head and Neck Cancer After External Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2018; 103:638-645. [PMID: 30391521 DOI: 10.1016/j.ijrobp.2018.10.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/04/2018] [Accepted: 10/24/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE To analyze the efficacy and safety of radioactive I-125 seed implantation in the treatment of recurrent head and neck tumors after radiation therapy. METHODS AND MATERIALS The data of 101 patients with recurrent head and neck cancer after radiation therapy who received computed tomography guided radioactive I-125 seed implantation were analyzed. The median previous cumulative external irradiation dose was 66 Gy, and the median dose to 90% of the target volume (D90) after operation was 117 Gy. The short-term efficacy was evaluated by Response Evaluation Criteria in Solid Tumors version 1.1, and the adverse event was evaluated by Common Terminology Criteria for Adverse Events version 4.0. RESULTS The 5-year local control rate was 26.6%, and the 5-year overall survival rate was 15.5%. Univariate analysis showed that factors related to local control rate included age, pathologic type, implantation site, lesion volume, and D90. The 5-year local control rate was 11.5% (2-year) if D90 was <120 Gy and 44.2% if D90 was ≥120 Gy (P = .001). Multivariate analysis showed that pathologic type, lesion volume, and D90 were independent factors related to local control (P = .002, 0, .014, respectively); Karnofsky performance status and lesion volume were independent factors associated with survival (P = .021 and 0, respectively). For the side effects, there were 26 cases of skin or mucosa ulceration (25.7%), 14 cases of pain (13.9%), and 2 cases of dry mouth (2%). The correlation between toxicity and dose had not been found. CONCLUSIONS Radioactive I-125 seed implantation in the treatment of recurrent head and neck cancer after radiation therapy showed acceptable efficacy and safety. Nonsquamous carcinoma, small lesion volume, and high dose (D90) were correlated with better local control.
Collapse
Affiliation(s)
- Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Suqing Tian
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Fuxin Guo
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Ran Peng
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Fei Xu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Jinghong Fan
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, P.R. China.
| |
Collapse
|
6
|
A systematic review of treating recurrent head and neck cancer: a reintroduction of brachytherapy with or without surgery. J Contemp Brachytherapy 2018; 10:454-462. [PMID: 30479623 PMCID: PMC6251444 DOI: 10.5114/jcb.2018.79399] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/21/2018] [Indexed: 11/23/2022] Open
Abstract
Purpose To review brachytherapy use in recurrent head and neck carcinoma (RHNC) with focus on its efficacy and complication rates. Material and methods A literature search of PubMed, Ovid, Google Scholar, and Scopus was conducted from 1990 to 2017. Publications describing treatment of RHNC with brachytherapy with or without surgery were included. The focus of this review is on oncologic outcomes and the safety of brachytherapy in the recurrent setting. Results Thirty studies involving RHNC treatment with brachytherapy were reviewed. Brachytherapy as adjunctive treatment to surgical resection appears to be associated with an improved local regional control and overall survival, when compared with the published rates for re-irradiation utilizing external beam radiotherapy (RT) or brachytherapy alone. Safety data remains variable with different isotopes and dose rates with implantable brachytherapy demonstrating a tolerable side effect profile. Conclusions Although surgery remains a mainstay treatment for RHNC, intraoperative interstitial brachytherapy delivery as adjunctive therapy may improve the treatment outcome and may be associated with fewer complication rates as compared to reirradiation using external beam radiotherapy. Further investigations are required to elucidate the role of brachytherapy for RHNC.
Collapse
|
7
|
Bonomo P, Cipressi S, Iermano C, Bonucci I, Masi L, Doro R, Favuzza V, Paiar F, Simontacchi G, Meattini I, Greto D, Agresti B, Livi L, Biti G. Salvage Stereotactic Re-irradiation with CyberKnife for Locally Recurrent Head and Neck Cancer: A Single Center Experience. TUMORI JOURNAL 2018. [DOI: 10.1177/1578.17202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Pierluigi Bonomo
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Samantha Cipressi
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Carmine Iermano
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Ivano Bonucci
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Laura Masi
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Raffaela Doro
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Virginia Favuzza
- CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza (IFCA), Florence
| | - Fabiola Paiar
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Gabriele Simontacchi
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Icro Meattini
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Daniela Greto
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Benedetta Agresti
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Lorenzo Livi
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giampaolo Biti
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| |
Collapse
|
8
|
Meregaglia M, Cairns J, Licitra L, Bossi P. The use of intensive radiological assessments in routine surveillance after treatment for head and neck cancer: An economic evaluation. Eur J Cancer 2018; 93:89-98. [DOI: 10.1016/j.ejca.2018.01.082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/06/2018] [Accepted: 01/21/2018] [Indexed: 01/15/2023]
|
9
|
[Reirradiation of head and neck cancers]. Cancer Radiother 2017; 21:521-526. [PMID: 28826697 DOI: 10.1016/j.canrad.2017.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/20/2017] [Accepted: 07/22/2017] [Indexed: 01/16/2023]
Abstract
Locoregional relapse in previously irradiated region for head and neck tumours is associated with a bad locoregional and distant prognosis. Reirradiation might be exclusive, or feasible in addition with surgery and/or chemotherapy, according to histopronostic factors. Data show that reirradiation is feasible with some severe toxicity due to the bad prognosis of this situation. Hyperfractionnated regimen with split course or normofractionnated regimen without split course are possible with similar efficacy. If tumour size is small, stereotactic ablative radiotherapy may be considered, and if the treatment centre has proton therapy, it could be proposed because of better organs at risk sparing. There is no standard regarding reirradiation schedules and several trials have to be done in order to determine the best technique. Nevertheless, it is agreed that a total dose of 60Gy (2Gy per fraction) is needed. Other trials testing the association with new systemic agents have to be performed, among them agents targeting the PD1/PD-L1 axis.
Collapse
|
10
|
Pollard C, Nguyen TP, Ng SP, Frank SJ, Garden AS, Gunn GB, Fuller CD, Beadle BM, Morrison WH, Shah SJ, Wang H, Tung S, Wang C, Ginsberg LD, Zafereo ME, Sturgis EM, Su SY, Hanna EY, Rosenthal DI, Phan J. Clinical outcomes after local field conformal reirradiation of patients with retropharyngeal nodal metastasis. Head Neck 2017; 39:2079-2087. [PMID: 28741749 DOI: 10.1002/hed.24872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/11/2017] [Accepted: 05/29/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The purpose of this study was to present our experience with retropharyngeal node reirradiation using highly conformal radiotherapy (RT). METHODS A retrospective screen of 2504 consecutively irradiated patients with head and neck malignancies between 2005 and 2015 identified 19 patients who underwent reirradiation for retropharyngeal node metastasis. Clinical and toxicity outcomes were assessed in these patients. RESULTS Thirteen patients (68%) had squamous cell carcinoma. Eleven patients (58%) received conventionally fractionated intensity-modulated radiotherapy (IMRT) or proton therapy, and 8 patients (42%) received single-fractionated or hypofractionated stereotactic RT. Fourteen patients (74%) received chemotherapy. Median follow-up was 14.7 months. The 1-year local control, locoregional control, overall survival, and progression-free survival rates were 100%, 94%, 92%, and 92%, respectively. Three patients (16%) experienced acute grade 3 toxicity and occurred in those treated with IMRT. There was no late grade ≥3 toxicity. CONCLUSION Retropharyngeal node reirradiation with conformal therapy is well tolerated and associated with excellent short-term disease control.
Collapse
Affiliation(s)
- Courtney Pollard
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Theresa P Nguyen
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sweet Ping Ng
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gary B Gunn
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Clifton D Fuller
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Beth M Beadle
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - William H Morrison
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shah J Shah
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - He Wang
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sam Tung
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Conjun Wang
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lawrence D Ginsberg
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark E Zafereo
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shirley Y Su
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David I Rosenthal
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack Phan
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
11
|
Facteurs pronostiques de la ré-irradiation des cancers des voies aérodigestives supérieures : revue de la littérature. Cancer Radiother 2017; 21:316-338. [DOI: 10.1016/j.canrad.2017.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/06/2017] [Accepted: 02/27/2017] [Indexed: 11/19/2022]
|
12
|
Kim YS. Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence. Radiat Oncol J 2017; 35:1-15. [PMID: 28395502 PMCID: PMC5398346 DOI: 10.3857/roj.2017.00122] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 01/11/2023] Open
Abstract
Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.
Collapse
Affiliation(s)
- Yeon Sil Kim
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
13
|
Baliga S, Kabarriti R, Ohri N, Haynes-Lewis H, Yaparpalvi R, Kalnicki S, Garg MK. Stereotactic body radiotherapy for recurrent head and neck cancer: A critical review. Head Neck 2016; 39:595-601. [PMID: 27997054 DOI: 10.1002/hed.24633] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/07/2016] [Accepted: 10/12/2016] [Indexed: 11/07/2022] Open
Abstract
The management of patients with recurrent head and neck cancers remains a challenging clinical dilemma. Concerns over toxicity with re-irradiation have limited its use in the clinical setting. Stereotactic Body Radiation Therapy (SBRT) has emerged as a highly conformal and precise type of radiotherapy and has the advantage of sparing normal tissue. Although SBRT is an attractive treatment modality, its use in the clinic is limited, given the technically challenging nature of the procedure. In this review, we attempt to provide a comprehensive overview of the role of re-irradiation in patients with recurrent head and neck cancers, with particular attention to the advent of SBRT and its use with systemic therapies such as cetuximab. In the second portion of this review, we present our systematic review of published experiences with SBRT in recurrent head and neck cancers in an attempt to provide data on response rates (RR), overall survival and toxicity. © 2016 Wiley Periodicals, Inc. Head Neck 39: 595-601, 2017.
Collapse
Affiliation(s)
- Sujith Baliga
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Rafi Kabarriti
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Nitin Ohri
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Hilda Haynes-Lewis
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Ravindra Yaparpalvi
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Madhur K Garg
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
14
|
Dagoglu N, Callery M, Moser J, Tseng J, Kent T, Bullock A, Miksad R, Mancias JD, Mahadevan A. Stereotactic Body Radiotherapy (SBRT) Reirradiation for Recurrent Pancreas Cancer. J Cancer 2016; 7:283-8. [PMID: 26918041 PMCID: PMC4747882 DOI: 10.7150/jca.13295] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/01/2015] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES After adjuvant or definitive radiation for pancreas cancer, there are limited conventional treatment options for recurrent pancreas cancer. We explored the role of (Stereotactic Body Radiotherapy) SBRT for reirradiation of recurrent pancreas Cancer. METHODS This is a retrospective study of patients reirradiated with SBRT for recurrent pancreas cancer. All patients were deemed unresectable and treated with systemic therapy. Fiducial gold markers were used. CT simulation was performed with oral and IV contrast and patients were treated with respiratory motion tracking in the Cyberknife(TM) system. RESULTS 30 patients (17 men and 13 women) with a median age of 67 years were included in the study. The median target volume was 41.29cc. The median prescription dose was 25Gy (24-36Gy) in a median of 5 fractions prescribed to a mean 78% isodose line. The median overall survival was 14 months. The 1 and 2 year local control was 78%. The worst toxicity included 3/30(10%) Grade III acute toxicity for pain, bleeding and vomiting. There was 2/30 (7%) Grade III long-term bowel obstructions. CONCLUSIONS SBRT can be a useful and tolerable option for patients with recurrent pancreas cancer after prior radiation.
Collapse
Affiliation(s)
| | | | | | | | | | - Andrea Bullock
- 3. Department of Medical Oncology; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA
| | - Rebecca Miksad
- 3. Department of Medical Oncology; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA
| | | | | |
Collapse
|
15
|
Unresectable Recurrent Squamous Cell Carcinoma of the Temporal Bone Treated by Induction Chemotherapy Followed by Concurrent Chemo-Reirradiation: A Case Report and Review of the Literature. Otol Neurotol 2015. [PMID: 26208130 DOI: 10.1097/mao.0000000000000837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To report a rare case of recurrent temporal bone carcinoma encasing the carotid artery. PATIENT A 54-year-old man underwent mastoidectomy combined with adjuvant chemoradiotherapy of squamous cell carcinoma of the temporal bone. He developed metastatic disease and received parotidectomy and lymph node dissection. Three months later, the magnetic resonance imaging scan showed that the tumor had relapsed and invaded the carotid artery. INTERVENTION The patient completed TPF-C induction chemotherapy (docetaxel, cisplatin, 5-fluorouracil, cetuximab), followed by concurrent chemotherapy with reirradiation. RESULTS Magnetic resonance imaging revealed a complete response of tumor 1 month after treatment. The patient had no detectable recurrence after 53 months of follow-up. CONCLUSION Concurrent chemotherapy with reirradiation is a potential curative treatment option for patients who have unresectable recurrent squamous cell carcinoma of the temporal bone.
Collapse
|
16
|
Management of Recurrent HPV-Related Oropharyngeal Cancer. CURRENT OTORHINOLARYNGOLOGY REPORTS 2015. [DOI: 10.1007/s40136-015-0080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
17
|
Tagliaferri L, Bussu F, Rigante M, Gambacorta MA, Autorino R, Mattiucci GC, Fionda B, Miccichè F, Placidi E, Balducci M, Galli J, Valentini V, Paludetti G, Kovacs G. Endoscopy-guided brachytherapy for sinonasal and nasopharyngeal recurrences. Brachytherapy 2015; 14:419-25. [PMID: 25620162 DOI: 10.1016/j.brachy.2014.11.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/20/2014] [Accepted: 11/25/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE/PURPOSE To evaluate the preliminary results of perioperative endoscopy-guided brachytherapy (BT) in recurrent sinonasal and nasopharyngeal tumors already treated for their primary tumor with a full course of radiotherapy. METHODS AND MATERIALS Patients with recurrence and already treated with a previous full course of radiotherapy >65 Gy who underwent BT from December 2010 to January 2014 were taken into account for this work. Macroscopic disease was resected by an endoscopic approach, and catheters for BT were endoscopically positioned and fixed at the same time on the surgical bed. Surgery was performed under electromagnetic navigation guidance. The irradiation dose was 30 Gy in 12 fractions, 2.5 Gy each, twice a day, in 6 days. RESULTS We performed the endoscopy-guided BT 11 times in 9 patients; in two cases, no previous radiation therapy had been performed; and in one case, followup was too short to be considered. A total of 6 patients were eligible for the analysis. One patient underwent BT three times because of previous target margin recurrences. There were no immediate complications. The median and mean followups were 21 and 19 months, respectively. The median V90 and V85% were 93% and 95%, respectively. In one case, we had a transient deficit of the VI cranial nerve (G3), and in another case, we diagnosed a noncomplicated osteonecrosis (G2). The median disease-free survival is 12 months, and the median overall survival is 23 months. CONCLUSIONS The combination of endoscopy and BT seems to be a safe option for treating recurrent sinonasal and nasopharyngeal tumors.
Collapse
Affiliation(s)
- Luca Tagliaferri
- Department of Radiation Oncology, Catholic University, Rome, Italy
| | - Francesco Bussu
- Department of Otorhinolaringoiatry, Catholic University, Rome, Italy.
| | - Mario Rigante
- Department of Otorhinolaringoiatry, Catholic University, Rome, Italy
| | | | - Rosa Autorino
- Department of Radiation Oncology, Catholic University, Rome, Italy
| | | | - Bruno Fionda
- Department of Radiation Oncology, Catholic University, Rome, Italy
| | | | | | - Mario Balducci
- Department of Radiation Oncology, Catholic University, Rome, Italy
| | - Jacopo Galli
- Department of Otorhinolaringoiatry, Catholic University, Rome, Italy
| | | | - Gaetano Paludetti
- Department of Otorhinolaringoiatry, Catholic University, Rome, Italy
| | - Gyoergy Kovacs
- Interdisciplinary Brachytherapy Unit, University of Lübeck & University Hospital S-H, Campus Lübeck, Germany
| |
Collapse
|
18
|
Krengli M, Apicella G, Deantonio L, Paolini M, Masini L. Stereotactic radiation therapy for skull base recurrences: Is a salvage approach still possible? Rep Pract Oncol Radiother 2014; 20:430-9. [PMID: 26696783 DOI: 10.1016/j.rpor.2014.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/30/2014] [Accepted: 10/10/2014] [Indexed: 12/22/2022] Open
Abstract
AIM A literature review was performed to analyse the role of stereotactic radiotherapy given in a single shot or in a fractionated fashion for recurrent skull base tumours in order to ascertain if it can be a real salvage approach. BACKGROUND The management of recurrent skull base tumours can have a curative or palliative intent and mainly includes surgery and RT. MATERIALS AND METHODS One-thousand-ninety-one articles were found in the search databases and the most relevant of them were analysed and briefly described. RESULTS Data on recurrences of meningioma, pituitary adenoma, craniopharyngioma, chordoma and chondrosarcoma, vestibular schwannoma, glomus jugulare tumours, olfactory neuroblastoma and recurrences from head and neck tumours invading the base of skull are reported highlighting the most relevant results in terms of local control, survival, side effects and complications. CONCLUSIONS In conclusion, it emerges that SRS and FSRT are effective and safe radiation modalities of realize real salvage treatment for recurrent skull base tumours.
Collapse
Affiliation(s)
- Marco Krengli
- Chair of Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy ; Department of Translational Medicine, University of "Piemonte Orientale", Novara, Italy
| | - Giuseppina Apicella
- Chair of Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy
| | - Letizia Deantonio
- Chair of Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy ; Department of Translational Medicine, University of "Piemonte Orientale", Novara, Italy
| | - Marina Paolini
- Chair of Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy
| | - Laura Masini
- Chair of Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy
| |
Collapse
|
19
|
Adams AK, Wise-Draper TM, Wells SI. Human papillomavirus induced transformation in cervical and head and neck cancers. Cancers (Basel) 2014; 6:1793-820. [PMID: 25226287 PMCID: PMC4190568 DOI: 10.3390/cancers6031793] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/13/2014] [Accepted: 08/25/2014] [Indexed: 12/18/2022] Open
Abstract
Human papillomavirus (HPV) is one of the most widely publicized and researched pathogenic DNA viruses. For decades, HPV research has focused on transforming viral activities in cervical cancer. During the past 15 years, however, HPV has also emerged as a major etiological agent in cancers of the head and neck, in particular squamous cell carcinoma. Even with significant strides achieved towards the screening and treatment of cervical cancer, and preventive vaccines, cervical cancer remains the leading cause of cancer-associated deaths for women in developing countries. Furthermore, routine screens are not available for those at risk of head and neck cancer. The current expectation is that HPV vaccination will prevent not only cervical, but also head and neck cancers. In order to determine if previous cervical cancer models for HPV infection and transformation are directly applicable to head and neck cancer, clinical and molecular disease aspects must be carefully compared. In this review, we briefly discuss the cervical and head and neck cancer literature to highlight clinical and genomic commonalities. Differences in prognosis, staging and treatment, as well as comparisons of mutational profiles, viral integration patterns, and alterations in gene expression will be addressed.
Collapse
Affiliation(s)
- Allie K Adams
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | - Trisha M Wise-Draper
- Division of Hematology/Oncology, University of Cincinnati Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA.
| | - Susanne I Wells
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| |
Collapse
|
20
|
Vargo JA, Kubicek GJ, Ferris RL, Duvvuri U, Johnson JT, Ohr J, Clump DA, Burton S, Heron DE. Adjuvant stereotactic body radiotherapy ± cetuximab following salvage surgery in previously irradiated head and neck cancer. Laryngoscope 2014; 124:1579-84. [DOI: 10.1002/lary.24441] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 09/10/2013] [Accepted: 09/16/2013] [Indexed: 11/10/2022]
Affiliation(s)
- John A. Vargo
- Department of Radiation Oncology; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - Gregory J. Kubicek
- Department of Radiation Oncology; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - Robert L. Ferris
- Department of Radiation Oncology; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
- Division of Head and Neck Surgery; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - Umamaheswar Duvvuri
- Division of Head and Neck Surgery; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - Jonas T. Johnson
- Division of Head and Neck Surgery; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - James Ohr
- Department of Otolaryngology, and Division of Medical Oncology , Department of Medicine; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - David A. Clump
- Department of Radiation Oncology; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - Steven Burton
- Department of Radiation Oncology; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| | - Dwight E. Heron
- Department of Radiation Oncology; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
- Division of Head and Neck Surgery; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania U.S.A
| |
Collapse
|
21
|
Hezel M, Kurzweg T, Münscher A, Schafhausen P, Knecht R. [Therapy of recurrent and metastatic squamous cell carcinoma of the head and neck : highlights of the ASCO Meeting 2013]. HNO 2013; 61:911-3. [PMID: 24221219 DOI: 10.1007/s00106-013-2768-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In many cases squamous cell carcinoma of the head and neck is already in an advanced stage when initially diagnosed. Despite definitive treatment, loco-regional recurrences and metastases are common and patients ultimately require systemic treatment. Epidermal growth factor receptor (EGFR) inhibitors have proven to significantly prolong survival and have therefore become the first line treatment in recurrent and metastatic squamous cell carcinoma of the head and neck in addition to platinum and 5-FU treatment. Good results have also been reported for EGFR inhibitors in cases where platinum-based treatment has failed. Further strategies, such as salvage surgery, platinum-based chemotherapy, targeted therapy, chemoradiation and reirradiation are currently under investigation to reduce toxicity and improve survival and health-related quality of life.
Collapse
Affiliation(s)
- M Hezel
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf-Hals-Tumorzentrum des Universitären Cancer Center Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | | | | | | | | |
Collapse
|