Outcomes following reirradiation of patients with head and neck cancer.

BACKGROUND This study reports the outcomes for patients with head and neck cancer who received reirradiation with palliative or curative intent. METHODS A retrospective review of 41 patients treated with curative (n = 28) or palliative (n = 13) reirradiation was conducted. Survival was calculated from the start of the reirradiation. Radiation-related toxicities were classified according to Radiation Therapy Oncology Group criteria. Disease-related problems included adverse events during or after reirradiation that were not directly related to reirradiation. RESULTS The observed 1-year survival for all patients was 39.0% (23.0% palliative, 46.3% curative). Median survival for all patients was 10.2 months. Seventy-five percent of curative and 53.8% of palliative patients had grade 3 or 4 radiation-related toxicities and/or major disease-related problems. CONCLUSION A second course of radiotherapy in patients with head and neck cancer should be offered with a clear understanding that survival is poor and many of these patients will suffer severe radiation-related or disease-related insults to their quality of life during and after treatment.