Re-irradiation with curative intent in patients with squamous cell carcinoma of the head and neck

a national survey of usual practice on behalf of the Italian Association of Radiation Oncology (AIRO)

Italian Association of Radiation Oncology (AIRO)

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To report the results of a national survey investigating the pattern of practice of curative re-irradiation (ReRT) for recurrent squamous cell carcinoma of the head and neck.

METHODS: In March 2016, a 22-item, 4-section questionnaire was sent to all Italian Radiation Oncology centers. Sections were focused on assessing the expertise level of each center and collecting specific information on reRT prescription modalities in the adjuvant and definitive settings.

RESULTS: Overall, 77 centers completed the survey. The majority (50/77, 64.9%) of participating radiation oncologists were senior consultants (> 10 years of experience). Of the responding centers, 63 (81.8%) performed curative ReRT, while 14 (18.1%) did not, mainly (5/14, 35.7%) due to the avoidance of severe toxicity. The use of adjuvant ReRT was reported by less than half of the interviewed radiation oncologists (36/77, 46.7%). In case of unresectable local recurrence, definitive ReRT was claimed to be adopted in 55/77 (71.4%) for non-nasopharyngeal and 47/77 (61%) for nasopharyngeal cancer. The preferred treatment technique was Intensity Modulated Radiation Therapy (IMRT) followed by Stereotactic Body Radiation Therapy (SBRT). When IMRT was applied, the most common (19/55 responders, 34.5%) selection of treatment volume consisted of the Gross Tumor Volume (GTV) + 0.5 cm margin to account for microscopic disease.

CONCLUSION: Despite the absence of definitive evidence-based recommendations, a possible consideration for ReRT in case of unresectable recurrent head and neck cancer was reported by over 80% of radiation oncologists taking part in the national survey.

Original languageEnglish
Pages (from-to)561-567
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume275
Issue number2
DOIs
Publication statusPublished - Feb 2018

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Radiation Oncology
Radiotherapy
Nasopharyngeal Neoplasms
Head and Neck Neoplasms
Consultants
Tumor Burden
Prescriptions
Re-Irradiation
Carcinoma, squamous cell of head and neck
Surveys and Questionnaires
Recurrence
Therapeutics
Radiation Oncologists

Keywords

  • Carcinoma, Squamous Cell/radiotherapy
  • Head and Neck Neoplasms/radiotherapy
  • Humans
  • Italy
  • Nasopharyngeal Neoplasms/radiotherapy
  • Practice Patterns, Physicians'/statistics & numerical data
  • Radiation Oncology
  • Radiotherapy, Intensity-Modulated/statistics & numerical data
  • Re-Irradiation/statistics & numerical data
  • Squamous Cell Carcinoma of Head and Neck
  • Surveys and Questionnaires

Cite this

@article{36892959b0e543e7880ec3eeaa2a2246,
title = "Re-irradiation with curative intent in patients with squamous cell carcinoma of the head and neck: a national survey of usual practice on behalf of the Italian Association of Radiation Oncology (AIRO)",
abstract = "OBJECTIVE: To report the results of a national survey investigating the pattern of practice of curative re-irradiation (ReRT) for recurrent squamous cell carcinoma of the head and neck.METHODS: In March 2016, a 22-item, 4-section questionnaire was sent to all Italian Radiation Oncology centers. Sections were focused on assessing the expertise level of each center and collecting specific information on reRT prescription modalities in the adjuvant and definitive settings.RESULTS: Overall, 77 centers completed the survey. The majority (50/77, 64.9{\%}) of participating radiation oncologists were senior consultants (> 10 years of experience). Of the responding centers, 63 (81.8{\%}) performed curative ReRT, while 14 (18.1{\%}) did not, mainly (5/14, 35.7{\%}) due to the avoidance of severe toxicity. The use of adjuvant ReRT was reported by less than half of the interviewed radiation oncologists (36/77, 46.7{\%}). In case of unresectable local recurrence, definitive ReRT was claimed to be adopted in 55/77 (71.4{\%}) for non-nasopharyngeal and 47/77 (61{\%}) for nasopharyngeal cancer. The preferred treatment technique was Intensity Modulated Radiation Therapy (IMRT) followed by Stereotactic Body Radiation Therapy (SBRT). When IMRT was applied, the most common (19/55 responders, 34.5{\%}) selection of treatment volume consisted of the Gross Tumor Volume (GTV) + 0.5 cm margin to account for microscopic disease.CONCLUSION: Despite the absence of definitive evidence-based recommendations, a possible consideration for ReRT in case of unresectable recurrent head and neck cancer was reported by over 80{\%} of radiation oncologists taking part in the national survey.",
keywords = "Carcinoma, Squamous Cell/radiotherapy, Head and Neck Neoplasms/radiotherapy, Humans, Italy, Nasopharyngeal Neoplasms/radiotherapy, Practice Patterns, Physicians'/statistics & numerical data, Radiation Oncology, Radiotherapy, Intensity-Modulated/statistics & numerical data, Re-Irradiation/statistics & numerical data, Squamous Cell Carcinoma of Head and Neck, Surveys and Questionnaires",
author = "{Italian Association of Radiation Oncology (AIRO)} and Marta Maddalo and Pierluigi Bonomo and Liliana Belgioia and Almalina Bacigalupo and Vittorio Donato and Daniela Alterio and Ester Orlandi and Angela Argenone and Anna Merlotti and Daniela Musio and Marianna Trignani and Stefano Ursino and Stefano Arcangeli and Carlo Furlan and Osti, {Mattia Falchetto}",
year = "2018",
month = "2",
doi = "10.1007/s00405-017-4853-8",
language = "English",
volume = "275",
pages = "561--567",
journal = "European Archives of Oto-Rhino-Laryngology",
issn = "0937-4477",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Re-irradiation with curative intent in patients with squamous cell carcinoma of the head and neck

T2 - a national survey of usual practice on behalf of the Italian Association of Radiation Oncology (AIRO)

AU - Italian Association of Radiation Oncology (AIRO)

AU - Maddalo, Marta

AU - Bonomo, Pierluigi

AU - Belgioia, Liliana

AU - Bacigalupo, Almalina

AU - Donato, Vittorio

AU - Alterio, Daniela

AU - Orlandi, Ester

AU - Argenone, Angela

AU - Merlotti, Anna

AU - Musio, Daniela

AU - Trignani, Marianna

AU - Ursino, Stefano

AU - Arcangeli, Stefano

AU - Furlan, Carlo

AU - Osti, Mattia Falchetto

PY - 2018/2

Y1 - 2018/2

N2 - OBJECTIVE: To report the results of a national survey investigating the pattern of practice of curative re-irradiation (ReRT) for recurrent squamous cell carcinoma of the head and neck.METHODS: In March 2016, a 22-item, 4-section questionnaire was sent to all Italian Radiation Oncology centers. Sections were focused on assessing the expertise level of each center and collecting specific information on reRT prescription modalities in the adjuvant and definitive settings.RESULTS: Overall, 77 centers completed the survey. The majority (50/77, 64.9%) of participating radiation oncologists were senior consultants (> 10 years of experience). Of the responding centers, 63 (81.8%) performed curative ReRT, while 14 (18.1%) did not, mainly (5/14, 35.7%) due to the avoidance of severe toxicity. The use of adjuvant ReRT was reported by less than half of the interviewed radiation oncologists (36/77, 46.7%). In case of unresectable local recurrence, definitive ReRT was claimed to be adopted in 55/77 (71.4%) for non-nasopharyngeal and 47/77 (61%) for nasopharyngeal cancer. The preferred treatment technique was Intensity Modulated Radiation Therapy (IMRT) followed by Stereotactic Body Radiation Therapy (SBRT). When IMRT was applied, the most common (19/55 responders, 34.5%) selection of treatment volume consisted of the Gross Tumor Volume (GTV) + 0.5 cm margin to account for microscopic disease.CONCLUSION: Despite the absence of definitive evidence-based recommendations, a possible consideration for ReRT in case of unresectable recurrent head and neck cancer was reported by over 80% of radiation oncologists taking part in the national survey.

AB - OBJECTIVE: To report the results of a national survey investigating the pattern of practice of curative re-irradiation (ReRT) for recurrent squamous cell carcinoma of the head and neck.METHODS: In March 2016, a 22-item, 4-section questionnaire was sent to all Italian Radiation Oncology centers. Sections were focused on assessing the expertise level of each center and collecting specific information on reRT prescription modalities in the adjuvant and definitive settings.RESULTS: Overall, 77 centers completed the survey. The majority (50/77, 64.9%) of participating radiation oncologists were senior consultants (> 10 years of experience). Of the responding centers, 63 (81.8%) performed curative ReRT, while 14 (18.1%) did not, mainly (5/14, 35.7%) due to the avoidance of severe toxicity. The use of adjuvant ReRT was reported by less than half of the interviewed radiation oncologists (36/77, 46.7%). In case of unresectable local recurrence, definitive ReRT was claimed to be adopted in 55/77 (71.4%) for non-nasopharyngeal and 47/77 (61%) for nasopharyngeal cancer. The preferred treatment technique was Intensity Modulated Radiation Therapy (IMRT) followed by Stereotactic Body Radiation Therapy (SBRT). When IMRT was applied, the most common (19/55 responders, 34.5%) selection of treatment volume consisted of the Gross Tumor Volume (GTV) + 0.5 cm margin to account for microscopic disease.CONCLUSION: Despite the absence of definitive evidence-based recommendations, a possible consideration for ReRT in case of unresectable recurrent head and neck cancer was reported by over 80% of radiation oncologists taking part in the national survey.

KW - Carcinoma, Squamous Cell/radiotherapy

KW - Head and Neck Neoplasms/radiotherapy

KW - Humans

KW - Italy

KW - Nasopharyngeal Neoplasms/radiotherapy

KW - Practice Patterns, Physicians'/statistics & numerical data

KW - Radiation Oncology

KW - Radiotherapy, Intensity-Modulated/statistics & numerical data

KW - Re-Irradiation/statistics & numerical data

KW - Squamous Cell Carcinoma of Head and Neck

KW - Surveys and Questionnaires

U2 - 10.1007/s00405-017-4853-8

DO - 10.1007/s00405-017-4853-8

M3 - Article

VL - 275

SP - 561

EP - 567

JO - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

IS - 2

ER -