A nomogram to predict loco-regional control after re-irradiation for head and neck cancer Journal Article
| Authors: | Riaz, N.; Hong, J. C.; Sherman, E. J.; Morris, L.; Fury, M.; Ganly, I.; Wang, T. J.; Shi, W.; Wolden, S. L.; Jackson, A.; Wong, R. J.; Zhang, Z.; Rao, S. D.; Lee, N. Y. |
| Article Title: | A nomogram to predict loco-regional control after re-irradiation for head and neck cancer |
| Abstract: | Background and purpose Loco-regionally recurrent head and neck cancer (HNC) in the setting of prior radiotherapy carries significant morbidity and mortality. The role of re-irradiation (re-RT) remains unclear due to toxicity. We determined prognostic factors for loco-regional control (LRC) and formulated a nomogram to help clinicians select re-RT candidates. Material and methods From July 1996 to April 2011, 257 patients with recurrent HNC underwent fractionated re-RT. Median prior dose was 65 Gy and median time between RT was 32.4 months. One hundred fifteen patients (44%) had salvage surgery and 172 (67%) received concurrent chemotherapy. Median re-RT dose was 59.4 Gy and 201 (78%) patients received IMRT. Multivariate Cox proportional hazards were used to identify independent predictors of LRC and a nomogram for 2-year LRC was constructed. Results Median follow-up was 32.6 months. Two-year LRC and overall survival (OS) were 47% and 43%, respectively. Recurrent stage (P = 0.005), non-oral cavity subsite (P < 0.001), absent organ dysfunction (P < 0.001), salvage surgery (P < 0.001), and dose >50 Gy (P = 0.006) were independently associated with improved LRC. We generated a nomogram with concordance index of 0.68. Conclusion Re-RT can be curative, and our nomogram can help determine a priori which patients may benefit. © 2014 Elsevier Ireland Ltd. |
| Keywords: | adult; cancer chemotherapy; controlled study; aged; cancer surgery; survival rate; major clinical study; overall survival; cancer localization; cancer recurrence; intensity modulated radiation therapy; percutaneous endoscopic gastrostomy; plastic surgery; salvage therapy; stomach tube; cisplatin; fluorouracil; paclitaxel; cancer radiotherapy; radiation dose; cancer staging; follow up; carboplatin; computer assisted tomography; radiation injury; cetuximab; prediction; fibrosis; dysphagia; survival time; head and neck cancer; xerostomia; brachytherapy; contrast medium; nasopharynx carcinoma; cancer control; computer assisted radiotherapy; larynx; nomogram; trismus; bone necrosis; hearing impairment; retreatment; radiation necrosis; paranasal sinus; oropharynx carcinoma; induction chemotherapy; mouth cavity; nasopharynx; oropharynx; diagnostic test accuracy study; image guided radiotherapy; re-irradiation; unilateral blindness; head and neck disease; cancer prognosis; esophagus fistula; human; male; female; priority journal; article; recurrent head and neck cancer; carotid artery injury; loco regional control; neck fibrosis; organ dysfunction score |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 111 |
| Issue: | 3 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2014-06-01 |
| Start Page: | 382 |
| End Page: | 387 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2014.06.003 |
| PROVIDER: | scopus |
| PUBMED: | 24993329 |
| PMCID: | PMC5125394 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2014 -- CODEN: RAOND -- Source: Scopus |
