Repeat Radiation for Local Recurrence of Head and Neck Tumors and in Prostate Cancer.
Journal
Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967
Informations de publication
Date de publication:
06 Mar 2020
06 Mar 2020
Historique:
received:
26
02
2019
revised:
26
02
2019
accepted:
10
12
2019
entrez:
17
4
2020
pubmed:
17
4
2020
medline:
4
8
2020
Statut:
ppublish
Résumé
Recent advances in diagnostic methods and in radiotherapy now increasingly enable repeat radiotherapy with curative intent for the treatment of previously irradiated lesions. In this review, we present data on oncological outcomes and on acute and late sequelae, as far as these are currently known, in patients with head and neck tumors (HNT) or prostate cancer (PCa) who underwent repeat radiotherapy after prior radiotherapy with curative intent. This review is based on clinical series with over 20 patients that were published between May 1998 and April 2018 (HNT) or between October 1998 and October 2018 (PCa) and were retrieved by a search in the PubMed database. Most of the clinical series retrieved were retrospective and uncontrolled. There were 16 studies that included 2678 patients with recurrent head and neck tumors, and 8 that included 245 patients with recurrent prostate cancer. In patients with squamous cell carcinoma of the head and neck, intensity-modulated radio - therapy (IMRT) and stereotactic body radiotherapy (SBRT) yielded three-year survival rates of 47-57% but also produced substantial acute and late adverse effects. Most of the studies concerning recurrent PCa involved small patient groups. In these studies, repeat radiotherapy with SBRT yielded tumor control rates of 40-80% after 11-24 months of follow-up, with only mild acute toxicity. Although no comparative studies are available, it seems that modern external beam radiotherapy techniques can be used for repeat radiotherapy of locally recurrent head and neck tumors with curative intent after careful patient selection. Repeat radiotherapy of PCa must still be considered experimental, but initial results from small-scale trials are encouraging. The long-term adverse effects cannot yet be accessed. Patients should be selected by an interdisciplinary tumor board. This type of treatment is generally carried out in a specialized center.
Sections du résumé
BACKGROUND
BACKGROUND
Recent advances in diagnostic methods and in radiotherapy now increasingly enable repeat radiotherapy with curative intent for the treatment of previously irradiated lesions. In this review, we present data on oncological outcomes and on acute and late sequelae, as far as these are currently known, in patients with head and neck tumors (HNT) or prostate cancer (PCa) who underwent repeat radiotherapy after prior radiotherapy with curative intent.
METHODS
METHODS
This review is based on clinical series with over 20 patients that were published between May 1998 and April 2018 (HNT) or between October 1998 and October 2018 (PCa) and were retrieved by a search in the PubMed database.
RESULTS
RESULTS
Most of the clinical series retrieved were retrospective and uncontrolled. There were 16 studies that included 2678 patients with recurrent head and neck tumors, and 8 that included 245 patients with recurrent prostate cancer. In patients with squamous cell carcinoma of the head and neck, intensity-modulated radio - therapy (IMRT) and stereotactic body radiotherapy (SBRT) yielded three-year survival rates of 47-57% but also produced substantial acute and late adverse effects. Most of the studies concerning recurrent PCa involved small patient groups. In these studies, repeat radiotherapy with SBRT yielded tumor control rates of 40-80% after 11-24 months of follow-up, with only mild acute toxicity.
CONCLUSION
CONCLUSIONS
Although no comparative studies are available, it seems that modern external beam radiotherapy techniques can be used for repeat radiotherapy of locally recurrent head and neck tumors with curative intent after careful patient selection. Repeat radiotherapy of PCa must still be considered experimental, but initial results from small-scale trials are encouraging. The long-term adverse effects cannot yet be accessed. Patients should be selected by an interdisciplinary tumor board. This type of treatment is generally carried out in a specialized center.
Identifiants
pubmed: 32295696
pii: arztebl.2020.0167
doi: 10.3238/arztebl.2020.0167
pmc: PMC7171476
doi:
pii:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
167-174Références
Head Neck. 2017 Mar;39(3):533-540
pubmed: 27898191
Technol Cancer Res Treat. 2018 Jan 1;17:1533033818785496
pubmed: 29983098
Radiat Oncol. 2013 Oct 18;8:242
pubmed: 24139288
Oncotarget. 2017 Mar 17;8(33):55600-55612
pubmed: 28903447
Cancer Radiother. 2016 Jun;20(4):275-81
pubmed: 27342944
Curr Urol Rep. 2017 Aug;18(8):63
pubmed: 28688020
Radiat Oncol. 2017 Jun 9;12(1):95
pubmed: 28599663
Radiother Oncol. 2013 Nov;109(2):281-5
pubmed: 24262821
Asia Pac J Clin Oncol. 2017 Oct;13(5):e394-e401
pubmed: 27220486
Int J Radiat Oncol Biol Phys. 2018 Mar 1;100(3):595-605
pubmed: 28899556
Head Neck. 2016 Apr;38 Suppl 1:E1102-9
pubmed: 26451876
Eur J Nucl Med Mol Imaging. 2019 Jan;46(1):31-39
pubmed: 30350010
Ann Card Anaesth. 2015 Jan-Mar;18(1):74-82
pubmed: 25566715
Clin Oncol (R Coll Radiol). 2018 Feb;30(2):93-100
pubmed: 29208480
Int J Radiat Oncol Biol Phys. 2012 Feb 1;82(2):889-97
pubmed: 21277113
J Radiat Res. 2011;52(1):24-31
pubmed: 21127390
Int J Radiat Oncol Biol Phys. 2016 May 1;95(1):386-395
pubmed: 27084656
Chin Clin Oncol. 2017 Sep;6(Suppl 2):S10
pubmed: 28917248
Strahlenther Onkol. 2016 Jan;192(1):40-6
pubmed: 26314584
Strahlenther Onkol. 2017 Jul;193(7):525-533
pubmed: 28424840
Br J Radiol. 2015 Aug;88(1052):20150197
pubmed: 26055506
Am J Clin Oncol. 2010 Jun;33(3):286-93
pubmed: 19875950
Jpn J Clin Oncol. 2013 Feb;43(2):154-60
pubmed: 23242582
Pract Radiat Oncol. 2015 Nov-Dec;5(6):e615-23
pubmed: 26059509
Int J Radiat Oncol Biol Phys. 1996 Jul 1;35(4):721-30
pubmed: 8690638
Asia Pac J Clin Oncol. 2015 Jun;11(2):129-34
pubmed: 25132076
J Nucl Med. 2015 May;56(5):668-74
pubmed: 25791990
Radiother Oncol. 2013 Jun;107(3):305-9
pubmed: 23751378
Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1493-500
pubmed: 19464819
Oral Oncol. 2014 Nov;50(11):1104-8
pubmed: 25175942
Radiat Oncol. 2017 Mar 9;12(1):49
pubmed: 28274241
Prostate Cancer Prostatic Dis. 2018 Apr;21(1):4-21
pubmed: 29230009
Nuklearmedizin. 2017 Jun 13;56(3):73-81
pubmed: 28401244
Lancet Oncol. 2013 Feb;14(2):149-58
pubmed: 23306100