Reirradiation in squamous cell head and neck cancer: recent developments and future directions

Abstract

The purpose of this review is to highlight the most important developments in the management of recurrent or second primary head and neck carcinoma in previously irradiated areas by reirradiation that have been published in the medical literature in the past year. Recent research indicates that long-term survival can be achieved in a proportion of patients using more advanced chemo-reirradiation protocols in the primary as well as in postoperative reirradiation setting. Despite the promising results with regard to locoregional tumour control and survival, treatment-related acute and late morbidity remains of major concern. As an increasing number of patients currently receive more effective initial treatment regimens, recurrent and second primary tumours in previously irradiated areas nowadays may represent a more radio-resistant population than reported in previous studies. Therefore, full-dose chemo-reirradiation should only be applied in well selected cases.