Rare entities in head-and-neck cancer: salvage re-irradiation with carbon ions

Thomas Held,Paul Windisch,Sati Akbaba,Klaus Herfarth,Benjamin Farnia,Kristin Lang,Denise Bernhardt,Sebastian Adeberg,Stefan Rieken,Jürgen Debus,Peter Plinkert,Jakob Liermann,Christian Freudlsperger

doi:10.1186/s13014-019-1406-x

Abstract

BackgroundThe objective of this investigation is to evaluate the outcomes and toxicity of carbon-ion re-irradiation (CIR) in patients with rare head and neck cancers (HNC). There is a paucity of data regarding treatment approaches in this patient cohort, which we aim to address in this work.MethodsThirty-two (n = 32) consecutive patients with uncommon HNC treated between 2010 and 2017 were retrospectively analyzed in terms of clinical outcomes, patterns of failure, and toxicity.ResultsMucoepidermoid carcinoma (MEC) was the most common histology (22%). Patients received a median cumulative dose equivalent in 2 Gy fractions (EQD2) after CIR of 128.6 Gy (range, 105.8–146.5 Gy). The local and distant control rates 1 year after CIR were 66 and 72%. No serious acute or late toxicity (≥ grade 3) after CIR was observed.ConclusionsCIR may represent an effective and safe treatment alternative to palliative systemic therapies in these rare indications.

Highlights

Local recurrence or tumor progression after multimodal therapy for head and neck cancer (HNC) occurs in up to 30–50% of patients [1, 2]
The objective of this study is to investigate carbon-ion re-irradiation (CIR) treatment to address this paucity of data
Adverse events related to CIR were evaluated based on the patients’ medical records according to version 4.03 of the Common Terminology Criteria for Adverse Events (CTCAE)

Summary

Introduction

Local recurrence or tumor progression after multimodal therapy for head and neck cancer (HNC) occurs in up to 30–50% of patients [1, 2]. Treatment options for recurrent or progressive head and neck tumors are limited and generally associated with increased toxicities [3, 4]. This cohort of patients is frequently studied in clinical trials [5, 6]. The objective of this investigation is to evaluate the outcomes and toxicity of carbon-ion re-irradiation (CIR) in patients with rare head and neck cancers (HNC).

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Results

Discussion

Conclusion