Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer: A multi-institutional study of AIRO—Head and Neck working group

Ester Orlandi, Pierluigi Bonomo, Letizia Ferella, Elisa D'Angelo, Marta Maddalo, Daniela Alterio, Gabriele Infante, Almalina Bacigalupo, Angela Argenone, Nicola Alessandro Iacovelli, Isacco Desideri, Bruno Meduri, Luca Triggiani, Stefania Volpe, Liliana Belgioia, Francesco Dionisi, Domenico Attilio Romanello, Carlo Fallai, Rosalba Miceli

Research output: Contribution to journalArticle

Abstract

Background: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. Methods: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. Results: Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. Conclusion: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.

Original languageEnglish
Pages (from-to)3684-3692
Number of pages9
JournalHead and Neck
Volume41
Issue number10
DOIs
Publication statusPublished - Oct 1 2019

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Second Primary Neoplasms
Head and Neck Neoplasms
Neck
Survival
Kaplan-Meier Estimate
Population
Re-Irradiation

Keywords

  • head and neck cancers
  • modern RT techniques
  • overall survival
  • re-irradiation
  • toxicity

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer : A multi-institutional study of AIRO—Head and Neck working group. / Orlandi, Ester; Bonomo, Pierluigi; Ferella, Letizia; D'Angelo, Elisa; Maddalo, Marta; Alterio, Daniela; Infante, Gabriele; Bacigalupo, Almalina; Argenone, Angela; Iacovelli, Nicola Alessandro; Desideri, Isacco; Meduri, Bruno; Triggiani, Luca; Volpe, Stefania; Belgioia, Liliana; Dionisi, Francesco; Romanello, Domenico Attilio; Fallai, Carlo; Miceli, Rosalba.

In: Head and Neck, Vol. 41, No. 10, 01.10.2019, p. 3684-3692.

Research output: Contribution to journalArticle

Orlandi, E, Bonomo, P, Ferella, L, D'Angelo, E, Maddalo, M, Alterio, D, Infante, G, Bacigalupo, A, Argenone, A, Iacovelli, NA, Desideri, I, Meduri, B, Triggiani, L, Volpe, S, Belgioia, L, Dionisi, F, Romanello, DA, Fallai, C & Miceli, R 2019, 'Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer: A multi-institutional study of AIRO—Head and Neck working group', Head and Neck, vol. 41, no. 10, pp. 3684-3692. https://doi.org/10.1002/hed.25890
Orlandi, Ester ; Bonomo, Pierluigi ; Ferella, Letizia ; D'Angelo, Elisa ; Maddalo, Marta ; Alterio, Daniela ; Infante, Gabriele ; Bacigalupo, Almalina ; Argenone, Angela ; Iacovelli, Nicola Alessandro ; Desideri, Isacco ; Meduri, Bruno ; Triggiani, Luca ; Volpe, Stefania ; Belgioia, Liliana ; Dionisi, Francesco ; Romanello, Domenico Attilio ; Fallai, Carlo ; Miceli, Rosalba. / Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer : A multi-institutional study of AIRO—Head and Neck working group. In: Head and Neck. 2019 ; Vol. 41, No. 10. pp. 3684-3692.
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abstract = "Background: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. Methods: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. Results: Five-year OS was 43.5{\%} (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. Conclusion: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.",
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T1 - Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer

T2 - A multi-institutional study of AIRO—Head and Neck working group

AU - Orlandi, Ester

AU - Bonomo, Pierluigi

AU - Ferella, Letizia

AU - D'Angelo, Elisa

AU - Maddalo, Marta

AU - Alterio, Daniela

AU - Infante, Gabriele

AU - Bacigalupo, Almalina

AU - Argenone, Angela

AU - Iacovelli, Nicola Alessandro

AU - Desideri, Isacco

AU - Meduri, Bruno

AU - Triggiani, Luca

AU - Volpe, Stefania

AU - Belgioia, Liliana

AU - Dionisi, Francesco

AU - Romanello, Domenico Attilio

AU - Fallai, Carlo

AU - Miceli, Rosalba

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. Methods: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. Results: Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. Conclusion: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.

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