Table 2.
Re-irradiation studies using EBRT
| Study | Study design | No. of patients | Previous radiotherapy, Gy | No. of fractions, median | Total re-irradation dose, Gy | surgery | Systemic therapy | Follow up, mo | Efficacy | Severe toxicity |
|---|---|---|---|---|---|---|---|---|---|---|
| Heron,2008 | P | 25 | median:64.7 | 5 | 25–44 | / | NA | NA | 17.4% CR + PR,48% SD | / |
| Roh, 2009 | R | 36 | median:70.2 | 3 to 5 | median: 30 | / | 11.1% chemotherapy | 17.3 | 42.9% CR, 37.1% PR, 8.6%SD | Grade 3 acute toxicity:36.1% |
| 1-y OS:53.2%, 2-y OS: 30.9% | ||||||||||
| 1-y LRS:61%, 2-y LRS: 52.2% | ||||||||||
| Rwigema,2010 | R | 85 | median:74 | 1 to 5 | median:35 | NA | NA | 6 | 34% CR, 34%PR, 20%SD No grade 4–5 toxicities | |
| 1-y OS: 48.5%; 2-y OS:16.1%, median OS: 11.5 mo | ||||||||||
| 1-y LC:51.2%; 2-y LC:30.7% | ||||||||||
| Unger, 2010 | R | 65 | median:67 | 5 | median:30 | 13.80% | 50.8% chemotherapy | 16 | 54% CR, 27% PR Grade 4 toxicity:9% | |
| 2-y OS:41% median OS: 12 mo | ||||||||||
| 2-y LRC: 30% | ||||||||||
| Kawaguchi, 2010 | R | 22 | 40–65 | 2 to 5 | 20–42 | / | 100% chemotherapy | 24 | 64.3% CR, 7.1% PR, 7.1% SD Grade 3 toxicity: 22.7% | |
| Heron, 2011 | R | 70 | 68–70 | 5 | median:40 | / | 50% cetuximab | 21.3(SBRT) | SBRT only: 2-y OS: 21.1%; median OS: 14.8 mo | Grade 3 acute toxicity: 14.3% (SBRT only) |
| 24.8(SBRT + cetuximab) | SBRT + cetuximab: 2-y OS: 53.3%; median OS: 24.5 mo | |||||||||
| Rwigema,2011 | R | 96 | median:68.4 | 2 to 5 | I:15–28; II:30–36 | 40.6% cetuximab | 14 | 2-y LCR:57.8%(40-50 Gy);2-y LCR:31.7%(15-36 Gy) | Grade 3 acute toxicity:5.2% | |
| III: 40;IV: 44–50 | 2-y OS: 28.4%;median OS: 15 mo | |||||||||
| Vargo, 2012 | R | 150 | median:68.4 | 5 | 40–50 | / | 47% cetuximab | / | / | Improved QoL |
| Lartigau, 2013 | P | 56 | 6 | median:36 | / | 100% cetuximab | 11.4 | ORR:69.4% | Grade 3 toxicity:32.1% | |
| 1-y OS: 47.5.0%;median OS: 11.8 mo, median PFS: 7.1 mo | ||||||||||
| Vargo, 2014 | R | 28 | median:70 | 5 | 40–44 | / | 50% cetuximab | 14 | 1-y LRC: 51% | Grade ≥ 3 acute toxicity:0% |
| 1-y OS: 64% | ||||||||||
| Bonomo,2014 | R | 17 | median:66 | 5 | median:30 | / | 11.8% chemotherapy | 7.5 | 25% CR, 31% PR, 44% SD | Grade 3 toxicity: 6% |
| 5.88% cetuximab | Median PFS: 7 mo | |||||||||
| Kress,2014 | R | 85 | median:68 | 5 | median:30 | 29% | 45% chemotherapy | 17.3 | 2-y OS:24% | Grade 3 acute toxicity:2.4% |
| 25% cetuximab | 2-y LRC: 28% | |||||||||
| Vargo,2015 | P | 50 | median:70 | 5 | 40–44 | / | 100% cetuximab | 18 | 1-y OS:40%, median OS: 10 mo | Grade 3 acute toxicity: 6% |
| 1-y LCR: 60%;1-y LRC:37%; median PFS: 7 mo | ||||||||||
| Vargo,2017 | 414 | ≥ 40 | 5 | 40 (SBRT) | / | 55% cetuximab or chemotherapy(SBRT) | 28 | 2-y OS: 35.4% (IMRT) and 16.3% (SBRT) < 0.001 | Grade ≥ 3 acute toxicity:12.2%(SBRT) | |
| 33 | 60(IMRT) |
84% cetuximab or chemotherapy (IMRT) Median OS: 13.3 mo (IMRT) and 7.8 mo (SBRT) < 0.001. |
||||||||
| Ansinelli,2018 | R | 45 | NA | 5 | median:30 | NA | NA | 8.78 | 1-y OS: 37.76%; median OS: 9.23 | Grade 3 acute toxicity:2.2% |
| McBride, 2021 | P | 62 | NA | 3 | 27 | / | 51.6% nivolumab | 20.2 | Nivolumab: ORR 34.5%; PFS:1.9 mo; 1-y PFS: 32.2%; median OS: 14.2 mo | SBRT: grade 3–5 toxicity 13.3% |
| SBRT + nivolumab: ORR 29.0%; PFS: 2.6 mo;1-y PFS: 16.8%;median OS: 13.9 mo | ||||||||||
| Pellizzon,2022 | R | 11 | median:60 | 3 | median:40 | 100% | NA | 18 | 2-y OS: 80%; 4-y OS:53.5% | NA |
| 2-y DFS: 62.3%; 4-y OS:41.6% | ||||||||||
| Huang, 2022 | R | 74 | median:70 | 5 | 40–50 | 100% cetuximab | 9 | 25.0% CR,41.7%PR Grade 3 acute toxicity:17.6% | ||
| 2-y OS: 22.0%;median OS: 9 mo Grade ≥ 3 late toxicity:20.3% | ||||||||||
Abbreviations: OS, Overall Survival; LC, local control; LRC, locoregional control; DFS, disease free survival; PFS, progression free survival; CR, completed regression; PR, partial regression; SD, stable disease; ORR, objective regression rate