Dose-escalated re-irradiation improves outcome in locally recurrent head and neck cancer - Results of a large multicenter analysis
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Dose-escalated re-irradiation improves outcome in locally recurrent head and neck cancer - Results of a large multicenter analysis. / Roesch, Johannes; Oertel, Michael; Wegen, Simone; Trommer, Maike; Schleifenbaum, Julia; Hering, Dominik; Mäurer, Matthias; Knippen, Stefan; Dobiasch, Sophie; Waltenberger, Maria; von der Grün, Jens; Medenwald, Daniel; Süß, Christoph; Hoeck, Michael; Käsmann, Lukas; Fleischmann, Daniel F; Rühle, Alexander; Nicolay, Nils H; Fabian, Alexander; Löser, Anastassia; Heß, Sebastian; Tamaskovics, Bálint; Vinsensia, Maria; Hecht, Markus; Young DEGRO Trial Group.
in: RADIOTHER ONCOL, Jahrgang 181, 04.2023, S. 109380.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Dose-escalated re-irradiation improves outcome in locally recurrent head and neck cancer - Results of a large multicenter analysis
AU - Roesch, Johannes
AU - Oertel, Michael
AU - Wegen, Simone
AU - Trommer, Maike
AU - Schleifenbaum, Julia
AU - Hering, Dominik
AU - Mäurer, Matthias
AU - Knippen, Stefan
AU - Dobiasch, Sophie
AU - Waltenberger, Maria
AU - von der Grün, Jens
AU - Medenwald, Daniel
AU - Süß, Christoph
AU - Hoeck, Michael
AU - Käsmann, Lukas
AU - Fleischmann, Daniel F
AU - Rühle, Alexander
AU - Nicolay, Nils H
AU - Fabian, Alexander
AU - Löser, Anastassia
AU - Heß, Sebastian
AU - Tamaskovics, Bálint
AU - Vinsensia, Maria
AU - Hecht, Markus
AU - Young DEGRO Group
N1 - Copyright © 2022 Elsevier B.V. All rights reserved.
PY - 2023/4
Y1 - 2023/4
N2 - UNLABELLED: To determine efficacy and prognostic parameters of definitive re-irradiation of locoregionally recurrent squamous cell carcinoma of the head and neck (HNSCC).MATERIALS AND METHODS: Patients with locoregionally recurrent or second primary HNSCC undergoing re-irradiation with modern radiotherapy technique were eligible for this multicentric retrospective analysis. Main endpoints were overall survival (OS), progression-free survival (PFS) and locoregional control (LC). Univariate analyses were performed using the Kaplan Meier Method (log-rank). For multivariable analysis, Cox regression was used.RESULTS: A total of 253 patients treated between 2009 and 2020 at 16 university hospitals in Germany were included. The median follow up was 27.4 months (range 0.5-130). The median OS and PFS were 13.2 (CI: 10.7 - 15.7) months and 7.9 (CI: 6.7 - 9.1) months, respectively, corresponding to two-year OS and PFS rates of 29 % and 19 %. Rates of locoregional progression and "in-field-failure" were 62 % and 51 % after two years. Multivariable Cox regression analysis identified good ECOG performance status and high radiation dose as independent prognostic parameters for OS. Doses above 50 Gy (EQD2) achieved longer median OS of 17.8 months (vs 11.7 months, p < 0.01) and longer PFS of 9.6 months (vs 6.8 months, p < 0.01). In addition, there was a trend for worse survival in patients with tracheostomy (multivariable, p = 0.061). Concomitant systemic therapy did not significantly impact PFS or OS.CONCLUSION: Re-irradiation of locally recurrent or second primary HNSCC is efficient, especially if doses above 50 Gy (EQD2) are delivered. ECOG performance score was the strongest prognostic parameter for OS and PFS.
AB - UNLABELLED: To determine efficacy and prognostic parameters of definitive re-irradiation of locoregionally recurrent squamous cell carcinoma of the head and neck (HNSCC).MATERIALS AND METHODS: Patients with locoregionally recurrent or second primary HNSCC undergoing re-irradiation with modern radiotherapy technique were eligible for this multicentric retrospective analysis. Main endpoints were overall survival (OS), progression-free survival (PFS) and locoregional control (LC). Univariate analyses were performed using the Kaplan Meier Method (log-rank). For multivariable analysis, Cox regression was used.RESULTS: A total of 253 patients treated between 2009 and 2020 at 16 university hospitals in Germany were included. The median follow up was 27.4 months (range 0.5-130). The median OS and PFS were 13.2 (CI: 10.7 - 15.7) months and 7.9 (CI: 6.7 - 9.1) months, respectively, corresponding to two-year OS and PFS rates of 29 % and 19 %. Rates of locoregional progression and "in-field-failure" were 62 % and 51 % after two years. Multivariable Cox regression analysis identified good ECOG performance status and high radiation dose as independent prognostic parameters for OS. Doses above 50 Gy (EQD2) achieved longer median OS of 17.8 months (vs 11.7 months, p < 0.01) and longer PFS of 9.6 months (vs 6.8 months, p < 0.01). In addition, there was a trend for worse survival in patients with tracheostomy (multivariable, p = 0.061). Concomitant systemic therapy did not significantly impact PFS or OS.CONCLUSION: Re-irradiation of locally recurrent or second primary HNSCC is efficient, especially if doses above 50 Gy (EQD2) are delivered. ECOG performance score was the strongest prognostic parameter for OS and PFS.
U2 - 10.1016/j.radonc.2022.10.007
DO - 10.1016/j.radonc.2022.10.007
M3 - SCORING: Journal article
C2 - 36273736
VL - 181
SP - 109380
JO - RADIOTHER ONCOL
JF - RADIOTHER ONCOL
SN - 0167-8140
ER -