Reirradiation of head and neck squamous cell carcinomas: a pragmatic approach—part I: prognostic factors and indications to treatment

Introduction Reirradiation (reRT) of locally recurrent/second primary tumors of the head and neck region is a potentially curative treatment for patients not candidate to salvage surgery. Aim of the present study is to summarize available literature on both prognostic factors and indications to cura...

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Published in:Radiologia medica 2024-01, Vol.129 (1), p.160-173
Main Authors: Alterio, Daniela, Zaffaroni, Mattia, Bossi, Paolo, Dionisi, Francesco, Elicin, Olgun, Falzone, Andrea, Ferrari, Annamaria, Jereczek-Fossa, Barbara Alicja, Sanguineti, Giuseppe, Szturz, Petr, Volpe, Stefania, Scricciolo, Melissa
Format: Article
Language:English
Subjects:
Diagnostic Radiology
Head and Neck Neoplasms
Humans
Imaging
Interventional Radiology
Literature reviews
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local
Neuroradiology
Prognosis
Radiology
Radiotherapy
Re-Irradiation
Salvage Therapy
Squamous Cell Carcinoma of Head and Neck
Tumors
Ultrasound
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Summary:Introduction Reirradiation (reRT) of locally recurrent/second primary tumors of the head and neck region is a potentially curative treatment for patients not candidate to salvage surgery. Aim of the present study is to summarize available literature on both prognostic factors and indications to curative reRT in this clinical setting. Materials and methods A narrative review of the literature was performed on two topics: (1) patients’ selection according to prognostic factors and (2) dosimetric feasibility of reRT. Postoperative reRT and palliative intent treatments were out of the scope of this work. Results Patient-tumor and treatment-related prognostic factors were analyzed, together with dosimetric parameters concerning target volume and organs at risk. Based on available evidence, a stepwise approach has been proposed aiming to provide a useful tool to identify suitable candidates for curative reRT in clinical practice. This was then applied to two clinical cases, proposed at the end of this work. Conclusion A second course of RT in head and neck recurrence/second primary tumors is a personalized approach that can be offered to selected patients only in centers with expertise and dedicated equipment following a multidisciplinary team discussion.
ISSN:1826-6983
0033-8362
1826-6983
DOI:10.1007/s11547-023-01713-7