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HaYeon Kim, John A Vargo, Sushil Beriwal, David A Clump, James P Ohr, Robert L Ferris, Dwight E Heron, M Saiful Huq, Kenneth J Smith
BACKGROUND: The purpose of this study was to present our evaluation of the cost-effectiveness of salvage therapies for patients with recurrent head and neck cancer. METHODS: A Markov model was developed with 5 salvage treatment strategies: (1) platinum-based chemotherapy alone; (2) chemotherapy plus cetuximab; (3) stereotactic body radiotherapy (SBRT) alone; (4) SBRT plus cetuximab; and (5) intensity-modulated radiotherapy (IMRT) plus chemotherapy. Clinical parameters were obtained from comprehensive literature review and 2016 Medicare reimbursement...
March 14, 2018: Head & Neck
Charles T Lee, Yanqun Dong, Tianyu Li, Samuel Freedman, Jordan Anaokar, Thomas J Galloway, Mark A Hallman, Stephanie E Weiss, Shelly B Hayes, Robert A Price, C M Charlie Ma, Joshua E Meyer
PURPOSE: To evaluate the efficacy and toxicity of external beam reirradiation using a pulsed low-dose-rate (PLDR) technique. METHODS AND MATERIALS: We evaluated patients treated with PLDR reirradiation from 2009 to 2016 at a single institution. Toxicity was graded using the Common Terminology Criteria for Adverse Events, version 4.0, and local control was assessed using the Response Evaluation Criteria In Solid Tumors, version 1.1. On univariate analysis (UVA), the χ2 and Fisher exact tests were used to assess the toxicity outcomes...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
John A Vargo, Vitali Moiseenko, Jimm Grimm, Jimmy Caudell, David A Clump, Ellen Yorke, Jinyu Xue, Yevgeniy Vinogradskiy, Eduardo G Moros, Panayiotis Mavroidis, Sheena Jain, Issam El Naqa, Lawrence B Marks, Dwight E Heron
PURPOSE: Stereotactic body radiation therapy (SBRT) has emerged as a viable reirradiation strategy for locally recurrent previously-irradiated head and neck cancer. Doses in the literature have varied, which challenges clinical application of SBRT as well as clinical trial design. MATERIAL & METHODS: A working group was formed through the American Association of Physicists in Medicine to study tumor control probabilities for SBRT in head and neck cancer. We herein present a systematic review of the available literature addressing the dose/volume data for tumor control probability with SBRT in patients with locally recurrent previously-irradiated head and neck cancer...
January 31, 2018: International Journal of Radiation Oncology, Biology, Physics
D Menon, P G Chelakkot
BACKGROUND: Radiation therapy is a major treatment option in the management of primary central nervous system (CNS) tumors, though recurrences after primary treatment, especially in high-grade glial tumors, is a challenge for treating physician. Advances in the field of radiation have made reirradiation a feasible option in recurrent CNS tumors. MATERIALS AND METHODS: Details of patients with primary CNS lesions who presented between 2009 and 2016, with recurrent CNS lesions, and who were treated with reirradiation were retrieved from electronic medical records, as a departmental audit, and the outcome was analyzed...
April 2017: Indian Journal of Cancer
Maximilian Niyazi, Sebastian Adeberg, David Kaul, Anne-Laure Boulesteix, Nina Bougatf, Daniel F Fleischmann, Arne Grün, Anna Krämer, Claus Rödel, Franziska Eckert, Frank Paulsen, Kerstin A Kessel, Stephanie E Combs, Oliver Oehlke, Anca-Ligia Grosu, Annekatrin Seidlitz, Annika Lattermann, Mechthild Krause, Michael Baumann, Maja Guberina, Martin Stuschke, Volker Budach, Claus Belka, Jürgen Debus
BACKGROUND AND PURPOSE: Reirradiation (reRT) is a valid option with considerable efficacy in patients with recurrent high-grade glioma, but it is still not known which patients might be optimal candidates for a second course of irradiation. This study validated a newly developed prognostic score independently in an external patient cohort. MATERIAL AND METHODS: The reRT risk score (RRRS) is based on a linear combination of initial histology, clinical performance status, and age derived from a multivariable model of 353 patients...
February 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
R Kinj, K Bénézery, C Florescu, B Gery, J L Habrand, J Thariat
Malignant tumors of the head and neck have a predominantly regional recurrence pattern, with most deaths resulting from this progression. Optimization of re-radiation in recurrence setting is a major objective for these patients. Extensive research has been carried out with the PubMed search engine to find publications dealing with this topic. The first attempts to reirradiate the ORL sphere date back to the 1980s and the first to be performed by intensity modulation conformational radiotherapy (IMRT) date back to the late 1990s...
February 7, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Danielle N Margalit, Stuart J Wong
No abstract text is available yet for this article.
March 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Jimmy J Caudell, Matthew C Ward, Nadeem Riaz, Sara J Zakem, Musaddiq J Awan, Neal E Dunlap, Derek Isrow, Comron Hassanzadeh, John A Vargo, Dwight E Heron, Samuel Marcrom, Drexell H Boggs, Chandana A Reddy, Joshua Dault, James A Bonner, Kristin A Higgins, Jonathan J Beitler, Shlomo A Koyfman, Mitchell Machtay, Min Yao, Andy M Trotti, Farzan Siddiqui, Nancy Y Lee
PURPOSE: Limited data exist to guide the treatment technique for reirradiation of recurrent or second primary squamous carcinoma of the head and neck. We performed a multi-institution retrospective cohort study to investigate the effect of the elective treatment volume, dose, and fractionation on outcomes and toxicity. METHODS AND MATERIALS: Patients with recurrent or second primary squamous carcinoma originating in a previously irradiated field (≥40 Gy) who had undergone reirradiation with intensity modulated radiation therapy (IMRT); (≥40 Gy re-IMRT) were included...
March 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Brian J Gebhardt, John A Vargo, Diane Ling, Brianna Jones, Mary Mohney, David A Clump, James P Ohr, Robert L Ferris, Dwight E Heron
PURPOSE: To correlate carotid dose and risk of carotid blowout syndrome (CBOS) after stereotactic body radiation therapy (SBRT), hypothesizing that carotid dose does not correlate with CBOS. METHODS AND MATERIALS: We retrospectively reviewed 186 patients with recurrent, previously irradiated head and neck cancer treated between January 2008 and March 2013. Patients treated early in our experience with incomplete dosimetry were excluded from analysis (n = 111). A total of 75 patients were identified, providing 150 carotid arteries for analysis...
December 5, 2017: International Journal of Radiation Oncology, Biology, Physics
A Román A, C Jodar, A Perez-Rozos, Y Lupiañez-Perez, J A Medina, J Gomez-Millan
INTRODUCTION: Head and neck cancer recurrence is a therapeutic challenge due to the anatomical and functional constraints of the head and neck area. Stereotactic body radiotherapy (SBRT) is a high-precision technique of radiotherapy that consists of delivering a high ablative biological dose in 1-5 high-dose fractions, requiring a very high precision of the radiotherapy process with potential application in this clinical setting METHODS: Different studies that investigate the role of SBRT in the treatment of recurrent head and neck cancer have been reviewed...
December 15, 2017: Critical Reviews in Oncology/hematology
Alvaro Lassaletta, Douglas Strother, Normand Laperriere, Juliette Hukin, Magimairajan Issai Vanan, Karen Goddard, Lucie Lafay-Cousin, Donna L Johnston, Shayna Zelcer, Michal Zapotocky, Revathi Rajagopal, Vijay Ramaswamy, Cynthia Hawkins, Uri Tabori, Annie Huang, Ute Bartels, Eric Bouffet
OBJECTIVE: Clinical trials have failed to demonstrate a survival benefit of adjuvant chemotherapy in diffuse intrinsic pontine gliomas (DIPG). Radiation therapy (RT) is the only effective treatment thus far and reirradiation (rRT) has become an option at the time of progression. The aim of this study was to review the Canadian experience of DIPG rRT with a focus on the safety and possible efficacy of this approach. METHOD: We retrospectively reviewed the demographic, clinical, and RT data of patients with DIPG treated in Canada with rRT...
January 25, 2018: Pediatric Blood & Cancer
Carsten Nieder, Laurie E Gaspar, Dirk De Ruysscher, Matthias Guckenberger, Minesh P Mehta, Chad G Rusthoven, Arjun Sahgal, Eleni Gkika
BACKGROUND: Improved survival of patients with spinal bone metastases has resulted in an increased number of referrals for retreatment and repeat reirradiation. METHODS: A consortium of expert radiation oncologists (RO) has been established with the aim of providing treatment recommendations for challenging clinical scenarios for which there are no established guidelines. In this case, a patient developed local progression of a T5 vertebral lesion after two prior courses of palliative radiotherapy (time interval >12 months, assumed cumulative biologically equivalent dose in 2‑Gy fractions [EQD2] for spinal cord [alpha/beta 2 Gy] 75 Gy)...
January 23, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Kévin Beccaria, Arnault Tauziède-Espariat, Franck Monnien, Homa Adle-Biassette, Julien Masliah-Planchon, Gaëlle Pierron, Laetitia Maillot, Marc Polivka, Annie Laquerrière, Sandrine Bouillot-Eimer, Edouard Gimbert, Guillaume Gauchotte, Laurent Coffinet, Henri Sevestre, Claire Alapetite, Stéphanie Bolle, Dominic Thompson, Michel Zérah, Christian Sainte-Rose, Stéphanie Puget, Pascale Varlet
Pediatric chordomas are rare malignant neoplasms, and few data are available for optimizing therapeutic strategies and outcome. This study aimed at evaluating how best to manage them and to identify prognostic factors. This multicentric retrospective study included 40 children diagnosed with chordomas between 1966 and 2012. Clinical, radiological, and histopathological data, treatment modalities, and outcomes were reviewed. The median age was 12 years old. Most chordomas were histologically classical forms (45...
January 18, 2018: Journal of Neuropathology and Experimental Neurology
Jing Yan, Ju Yang, Yang Yang, Wei Ren, Juan Liu, Shanbao Gao, Shuangshuang Li, Weiwei Kong, Lijing Zhu, Mi Yang, Xiaoping Qian, Baorui Liu
BACKGROUND: Most tumor cell lines exhibited low-dose hyperradiosensitivity (LDHRS) to radiation doses lower than 0.3 Gy. Pulsed low-dose rate radiotherapy (PLDR) took advantage of LDHRS and maximized the tumor control process. In this study, we retrospectively analyzed patients receiving PLDR for refractory malignancies. PATIENTS AND METHODS: In total, 22 patients were included in our study: 9 females and 13 males. The median age was 61 years old. All the patients previously received multiline treatments and failed with an estimated survival less than 6 months...
January 3, 2018: Translational Oncology
Avani D Rao, Arif S Rashid, Qinyu Chen, Rosangela C Villar, Daria Kobyzeva, Kristina Nilsson, Karin Dieckmann, Alexey Nechesnyuk, Ralph Ermoian, Sara Alcorn, Shannon M MacDonald, Matthew M Ladra, Eric C Ford, Brian A Winey, Maria Luisa S Figueiredo, Michael J Chen, Stephanie A Terezakis
PURPOSE: Reirradiation has been proposed as an effective modality for recurrent central nervous system (CNS) malignancies in adults. We evaluated the toxicity and outcomes of CNS reirradiation in pediatric patients. METHODS AND MATERIALS: The data from pediatric patients <21 years of age at the initial diagnosis who developed a recurrent CNS malignancy that received repeat radiation therapy (RT) across 5 facilities in an international pediatric research consortium were retrospectively reviewed...
November 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Rei Umezawa, Naoya Murakami, Satoshi Nakamura, Akihisa Wakita, Hiroyuki Okamoto, Keisuke Tsuchida, Tairo Kashihara, Kazuma Kobayashi, Ken Harada, Kana Takahashi, Koji Inaba, Yoshinori Ito, Hiroshi Igaki, Koji Masui, Ken Yoshida, Keiichi Jingu, Nikolaos Tselis, Jun Itami
PURPOSE: The aim of this study was to investigate the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (ISBT) for reirradiation of locally recurrent uterine cervical cancer. METHODS AND MATERIALS: Between 2008 and 2015, patients receiving reirradiation using HDR-ISBT for local gross recurrence of uterine cervical cancer after definitive or postoperative radiotherapy were analyzed retrospectively. The prescription doses per fraction ranged 2...
December 21, 2017: Brachytherapy
J Attal, L Chaltiel, V Lubrano, J C Sol, C Lanaspeze, L Vieillevigne, I Latorzeff, E Cohen-Jonathan Moyal
We aimed to assess the efficacy of stereotactic irradiation for patients with recurrent high-grade glioma (HGG) and identify predictive factors of progression-free survival (PFS) and overall survival (OS) following reirradiation. We identified 32 patients with recurrent brain HGG who had been treated with either single-dose (stereotactic radiosurgery) or fractionated stereotactic radiotherapy between April 2008 and October 2015. Median follow up was 21.4 months (range 12.9-23.2) and median PFS was and 3.3 months (95% CI [2...
January 2018: Journal of Neuro-oncology
Gen Suzuki, Hideya Yamazaki, Norihiro Aibe, Koji Masui, Naomi Sasaki, Kotoha Tatekawa, Daisuke Shimizu, Takuya Kimoto, Takeshi Nishimura, Akihiro Nakashima, Kei Yamada
Reirradiation to previously irradiated peripheral bone metastases for pain has been shown to be safe and effective, but no specific trial has been completed to define the indications for reirradiation of patients with recurrent symptoms of metastatic bone disease. Thus, we aimed to assess the effectiveness and prognostic factors of reirradiation for painful bone metastases. To do so, we reviewed the cases of 14 patients with painful bone metastases who had undergone reirradiation at our hospital. A favorable pain response after reirradiation wasachieved in 50% (7/14) of the patients...
December 15, 2017: Kurume Medical Journal
Derek S Tsang, Elizabeth Burghen, Paul Klimo, Frederick A Boop, David W Ellison, Thomas E Merchant
PURPOSE: To determine the long-term outcomes and the optimal dose and volume for reirradiation of recurrent pediatric ependymoma. METHODS AND MATERIALS: Patients with recurrent ependymoma treated with a second course of fractionated radiation therapy (RT2) were reviewed retrospectively. Eligible patients had localized, intracranial ependymoma at initial diagnosis that was treated with focal radiation (RT1) without craniospinal irradiation (CSI) and were aged ≤21 years at the time of RT2...
February 1, 2018: International Journal of Radiation Oncology, Biology, Physics
A Schernberg, F Dhermain, S Ammari, S N Dumont, J Domont, A Patrikidou, J Pallud, É Dezamis, É Deutsch, G Louvel
PURPOSE: To analyse feasibility, prognostic factors and patterns of recurrence after concurrent reirradiation and bevacizumab for recurrent high-grade gliomas. PATIENTS AND METHODS: Between 2009 and 2015, 35 patients (median 57-year-old; 21 men, 14 women) with WHO grade III (n=11) or grade IV (n=24) gliomas were included in this retrospective and consecutive single-centre study. All patients received bevacizumab (median number of treatments: 12) concomitant with reirradiation (median dose: 45Gy, median number of fractions: 18) for recurrence with median 22 months (range: 5...
February 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
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