Reirradiation with intensity-modulated radiation therapy for recurrent or secondary head and neck cancer: Meta-analysis and systematic review

Jeongshim Lee, In Soo Shin, Woo Chul Kim, Won Sup Yoon, Woong Sub Koom, Chai Hong Rim

Research output: Contribution to journalArticle

Abstract

Background: To summarize outcomes of reirradiation with intensity-modulated radiotherapy (IMRT) for recurrent or secondary head and neck cancer (HNC). Methods: Primary endpoints were 2-year local control (LC) and overall survival (OS). Studies involving only recurrent nasopharyngeal patients with cancer were excluded. Results: A total of 17 studies involving 1635 patients were included. Fourteen (82%) of those were retrospective, and 15 (88%) were from single institution. Reirradiation with IMRT produced pooled 2-year LC and OS rates of 52% (95% confidence interval [CI], 46%-57%) and 46% (95% CI, 41%-50%), respectively. In subgroup analyses, the rate of salvage surgery (<42% vs ≥42%) influenced the pooled 2-year LC rate (45.9% vs 58.5%, P =.011). The pooled rates of late grade ≥ 3 and grade 5 toxicities were 26% (95% CI, 20%-32%) and 3.1% (95% CI, 2%-5%), respectively. Conclusions: Reirradiation with IMRT was an effective modality compared to historical outcomes in the pre-IMRT era.

Original languageEnglish
Pages (from-to)2473-2485
Number of pages13
JournalHead and Neck
Volume42
Issue number9
DOIs
Publication statusPublished - 2020 Sep 1

Keywords

  • head and neck cancer
  • intensity-modulated radiotherapy
  • meta-analysis
  • recurrence
  • reirradiation

ASJC Scopus subject areas

  • Otorhinolaryngology

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