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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.

Affiliations

Jeongshim Lee  1   2 , In-Soo Shin  3 , Woo Chul Kim  1 , Won Sup Yoon  4 , Woong Sub Koom  2 , Chai Hong Rim  4
1 Department of Radiation Oncology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
2 Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea.
3 Graduate School of Education, Dongguk University, Seoul, South Korea.
4 Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, South Korea.