TOXICITY AND SURVIVAL OUTCOMES OF HYPERFRACTIONATED SPLIT-COURSE REIRRADIATION AND DAILY CONCURRENT CHEMOTHERAPY IN LOCOREGIONALLY RECURRENT, PREVIOUSLY IRRADIATED HEAD AND NECK CANCERS

Background. Reirradiation of locoregionally recurrent, Previously irradiated head/neck cancer may be considered in situations of unresectability, medical inoperability, or adverse pathologic features found at salvage resection. Methods. Retrospective cohort analysis of toxicity and survival outcomes in locoregionally recurrent, previously irradiated patients with head/neck cancer treated with hyperfractionated split-course radiotherapy and concurrent chemotherapy. Results. Between March 1998 and September 2006, 39 patients initiated reirradiation at median of 2.3 years (range, 0.5 19) following prior radiotherapy. At median survivor follow-up of 24.5 months (range, 3-63.9), 10 patients are alive without evidence of disease. Median survival is 19.0 months, with estimated 1-, 2-, and 3-year overall survivals of 60.1%, 45.1%, and 22.7%, respectively. Locoregional failure was the predominant site of postreirradiation recurrence, Male sex, total radiotherapy dose, cycles of chemotherapy completed, and clinical response were associated with improved overall survival. Conclusions. Reirradiation can offer long-term survival for patients with recurrent, previously irradiated head/neck cancers. (C) 2009 Wiley Periodicals, Inc, 31: 493-502, 2009