Table 1 Re-irradiation studies using EBRT
From: Advancements of radiotherapy for recurrent head and neck cancer in modern era
Study | Study design | No. of patients | Previous radiotherapy, Gy | No. of fractions, median | Total re-irradation dose, Gy | surgery | Systemic therapy | Follow up, mo | Efficacy | Severe toxicity |
|---|---|---|---|---|---|---|---|---|---|---|
Crevoisier, 1998 | R | 169 | 65–70 |  | median:60 | NA | 84.6% chemotherapy | NA | 2-y OS: 10–25%;5-y OS:0–14% | Grade 3–4 acute toxicity: 46% |
|  |  |  |  |  |  |  |  |  | 2-y DFS: 3–14%;5-y DFS:0–8% | |
Crevoisier, 2001 | R | 25 | ≥ 45 |  | median: 60 | 100% | 100% chemotherapy | 66 | 4-y OS: 43% | Grade 3 acute toxicity: 40% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 2-y DFS:36%,5-y DFS:26% | Â |
Hehr, 2005 | P | 27 | 60-77.4 |  | 40–50 | / | 100% chemotherapy | 42 | 3-y OS: 18%; median OS:10 mo | Grade 3–4 acute toxicity: 40% |
Langendijk,2006 | P | 34 | NA |  | median:60 | / | / | 32 | 2-y LRC:27% | Grade 3–4 acute toxicity: 30% |
|  |  |  |  |  |  |  |  |  | 2-y OS:22%; median OS:13.2 mo | Grade 3–4 late toxicity: 23% |
Lee, 2006 | R | 105 | median:62 | Â | median:59.4 | 34.30% | 71.5% chemotherapy | 35 | 2-y LRRFS: 42% | Grade 3/4 acute toxicity: 23%/15% |
|  |  |  |  |  |  |  |  |  | 2-y OS:37%;median OS: 15 mo | Grade 3–4 late toxicity: 18.5% |
Salama, 2006 | R | 115 | median:67.5 |  | median:64.8 | 42.60% | 100% chemotherapy | 67.4 | 3-y OS: 22%; median OS: 11 mo | Grade 4–5 toxicity: 18.3% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 3-y PFS: 33%; median PFS:7 mo | |
Kasperts, 2006 | P | 39 | NA |  | 60–66 | 100% | / | 32 | 3-y LRC: 74% | Grade 3–4 late toxicity: 36% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 3-y OS: 48% | Â |
Janot, 2008 | P | 130 | ≥ 45 |  | median:60 | 100% | RT group 96.7% chemotherapy | RT group: 3-y OS: 25%, 3-y LRC: 58% | RT group: grade 3–4 acute toxicity: 28%,grade 3–4 late toxicity: 26% | |
Duprez, 2009 | R | 84 | median:69 | Â | median:69 | 22.60% | 20.2% chemotherapy | 19.8 | 2-y LRC: 48%, 5-y LRC: 40% | Grade 3 acute toxicity: 31.0% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 2-y OS: 35%, 5-y OS: 20%; median OS: 13.4 mo | Grade 3 late toxicity: 13.1% |
Sher, 2010 | R | 35 | median:67.5 |  | median:60 | 17% | 100% chemotherapy | 27.6 | 2-y LRC:67% | Grade 3–4 toxicity: 32.81%(TPF); 13.79%(PF) |
|  |  |  |  |  |  |  |  |  | 2-y OS: 48% | ≥ Grade 3 late toxicity:46% |
Jensen, 2010 | R | 73 | median: 66 | Â | median: 45 | / | 100% cetuximab | NA | median LRFS: 12.8 mo; median PFS: 8.6 mo; median OS: 12.5 mo (Re-RT) | Grade 3 late toxicity: 27.3% |
Zwicker, 2011 | R | 10 | median:66 | Â | median:50.4 | 40% | 100% cetuximab | 6.5 mo after reirradiation | 1-y OS: 40%; median OS: 7 mo | Grade 3 acute toxicity: 10% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 1-y LC:61%, 1-y LRC:44% | Grade 3 late toxicity: 20% |
Villaflor,2011 | P | 35 | NA |  | 60–70 | 61.00% | 100% chemotherapy | 45.6 | 1-y OS:43%;median OS: 9.8 mo | / |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 1-y PFS: 20%;median PFS: 9.5 mo | |
Peponi,2012 | R | 35 | median:66 | Â | median:55.8 | NA | NA | 12.9 | 1-y LC: 41%, 2-y LC:9% | Grade 3 acute toxicity: 20% |
|  |  |  |  |  |  |  |  |  | 1-y DFS: 30%, 2-y DFS: 7% | Grade 3–4 late toxicity:23% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 1-y OS: 42.9%, 2-y OS: 7.9% | |
Vormittag, 2012 | P | 31 | NA |  | 50–60 | / | 100% chemotherapy | NA | 2-y OS:10%;median OS: 8.4 mo | Grade 3–4 toxicity: 12.9% |
Balermpas,2012 | R | 18 | 55.8–72 |  | median:50.4 | / | 100% cetuximab | 1-y OS: 44%, 2-y OS: 19%; median OS: 8.38 mo | Grade2-3 toxicity:44% | |
Yang,2014 | R | 93 | 45–72 |  | NA | 71% | 100% chemotherapy | 14.2 | OS: not reach (PF);OS: 32.2 mo(TPF). Grade3-4 toxicity:32.8%(TPF) PFS: 27.5 mo(PF);PFS: 29.5 mo(TPF) 13.79%(PF) | |
Kakria,2015 | R | 31 | median:70 | Â | median:60 | 13% | 45.2% cetuximab or chemotherapy | 20.6 | 3-y DFS: 28.7%;median PFS: 12.7 mo | Grade 3 acute toxicity: 32.3% |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 3-y OS: 48.7%;median OS:24.8mo | |
Dornoff, 2015 | R | 66 | median: 64 | Â | median:50.4 | 24% | 50% cetuximab | 18.3 | 1-y OS: 44.4% (cetuximab), 45.5%(cisplatin) | Grade 3 toxicity: 57.6% (cetuximab), 51.5%(cisplatin) |
| Â | Â | Â | Â | Â | Â | Â | 50% chemotherapy | Â | ||
Curtis, 2016 | R | 81 | median:66 | Â | median:60(post-surgical RT) | 51.90% | 74.1% chemotherapy or cetuximab | 78.1 | 2-y OS: 48%; median OS:22 mo(RT) | NA |
| Â | Â | Â | Â | Â | median:69.6(definitive RT) | Â | Â | 2-y LRFS: 60%; median LRFS: 54.7 mo | ||
Takiar,2016 | R | 227 | median:65 | Â | median:60(post-surgical) | 50% | 67% chemotherapy | 24.7 after re-irradiation | Median OS: 27.7 mo (definitive RT); median OS: 22.8 (post-surgical RT) | Grade 3 toxicity: 30% |
| Â | Â | Â | Â | Â | median:66(definitive) | Â | Â | Â | ||
Caudell, 2017 | R | 505 | NA |  | median:60 | 49.20% | 77.40% | 21.5 | 2-y OS(defiitive group): 49.3%(≥ 66 Gy),34.2%(60-65.9 Gy), 30.4%(< 60 Gy) | ≥ 3 acute toxicity was 22.1% |
|  |  |  |  |  |  |  |  |  | 2-y LRF(defiitive group): 50.9%(≥ 66 Gy),67.5%(60-65.9 Gy) | ≥ 3 late toxicity was 16.7% |
Rühle,2020 | R | 48 | median:68.2 | 30 | median:59.4 | 35.40% | 60.7% cetuximab | / | 1-y OS: 62.4%, 2-y OS: 52.3%, 5-y OS: 34.3%; median OS: 25 mo | Grade 3 acute toxicity: 9.3% |
|  |  |  |  |  |  |  | 39.4% chemotherapy | 1-y PFS: 37.6%, 2-y PFS: 28.8%, 5-y PFS: 11.5%; median PFS: 9 mo | Grade 3–4 late toxicity:16.6% | |
Altay-Langguth, 2021 | P | 10 | median: 70.6(definitive) 64.8(adjuvant) | median:60 | NA | 100% Nivolumab | 11 | 1-y OS: 50%; median OS:11 mo 1-y PFS: 30%; median PFS: 8mo | Grade 3 toxicity: 20% (Nivolumab) | |
Roesch, 2022 | R | 253 | NA | Â | median:50 | / | 71% chemotherapy | 24.8 | 2-y OS: 29%; median OS: 13.2mo NA | |
| Â | Â | Â | Â | Â | Â | Â | Â | Â | 2-y PFS: 19%; median PFS: 7.9 mo | |