Table 2.
Treatment overview and results of particle re-irradiation for head and neck cancer
| Reference | N | Tumor entity | Previous RT: RT modality, Median dose |
Re-RT specifics: RT modality, Median dose |
Median time to local progression | Median Follow-up | Clinical Outcome | Toxicity |
|---|---|---|---|---|---|---|---|---|
| Romesser et al.6 | 92 | HNC 56.5% SCC |
61.4 Gy (RBE)(IQR 54.0–69.9) | Protons: 60.6 Gy (50.0–66.1) |
34.4 m | 13.3 m | Locoregional failure: 25.1% 1y OS: 65.2% 1y distant PFS: 84% |
Acute toxicity Grade III: mucositis (9.9%), dysphagia (9.1%), esophagitis (9.1%), dermatitis (3.3%) Late toxicity Grade III: skin toxicity (8.7%), dysphagia (7.1%) 9.1% reactive gastrostomy tube Two cases of Grade V hemorrhage |
| Phan et al.7 | 60 | HNC 66.67% SCC |
60 Gy (30-70) | Protons: Definitive RT 66 Gy (50-70) Adjuvant RT 61.5 Gy (50-70) |
47.1 m | 13.6 m/ 20.3m* | 50 patients finished RT*: 1y LRC 80.8% 1y PFS 60.1% 1y OS 81.3% |
30% Grade III acute toxicity 20% Grade III late toxicity 10% reactive feeding tubes Two patients with potential Grade V toxicity |
| Held et al.8 | 229 | HNC 54% ACC 26% SCC |
Photons/ or photons and carbon ions: 67.4 Gy (36.5–84) (EQD2) |
Carbon ions: 51 Gy (RBE) (36-66) |
46.8 m | 28.5 m | 1y LC 60% Median local PFS: 24.2 m Median OS: 26.1 m 1 year OS: 72% |
Acute toxicity Grade III: 3.1% Late toxicity Grade III: 14.5% |
| Hu et al.9 | 75 | NPC | IMRT 96%: 70 Gy (66–75.75) |
Carbon ions: 57.6 Gy (RBE) (50-66) |
29 m | 15.4 m | 1y local recurrence-free survival: 86.6% 1y PFS: 82.2% 1y OS: 98.1% |
Late toxicity Grade III or IV: 9.3% mucosal necrosis 1.3% xerostomia 1.3% temporal lobe necrosis |
RT: Radiotherapy, IMRT: Intensity modulated radiotherapy, 3DCRT: three-dimensional conformal radiation therapy, SRS: Stereotactic radiosurgery, FSRT: Fractionated stereotactic radiotherapy, RBE: relative biological effectiveness, BED: Biologically effective dose, CNS: Central nervous system, ICA: Internal carotid artery, m: months, y: years, PFS: Progression-free survival, OS: Overall survival, LC: local control, DC: distant control, LPFS: Local progression-free survival, ACC: Adenoid cystic carcinoma, SCC: Squamous cell carcinoma, HNC: Head and neck cancer, NPC: Nasopharynx cancer, IQR: interquartile range, EQD2: equivalent dose in 2 Gy fractions