Reirradiation of head and neck cancer: literature review

Abstract

Locoregional recurrences occurring in every second patient with locally advanced head and neck tumors are the main cause of treatment failures. The primary treatment modality for patients with the relapsed disease is surgery. However, the resection of head and neck cancer recurrences is effective for one-third of patients only because of the complex spatial anatomical localization of the relapses and the wide spread of the tumor. In most cases the use of different combinations of chemotherapy and immunotherapy can increase life expectancy by up to one year. In order to extend the lifespan of patients for a longer period researchers add to look for new, more effective treatments. Reirradiation improves local control of the tumor, however due to the use of large irradiated of the targets and high radiation doses delivered in the primary irradiation does not leave a tolerance reserve for surrounding healthy tissues, it is a cause of higher incidence of complications. That is why reirradiation has been used quite rarely. However, in recent years radiotherapy has made a big step in technical development and new radiotherapy techniques have appeared. The advanced treatment allows to reduce the radiation dose delivering to healthy tissues and the risk of late radiation-induced complications development. The review presents analysis published research on the effectiveness of head and neck tumors reirradiation with various radiotherapy techniques available in Russian and foreign scientific literature, as well as physico-dosimetric comparison of the methods and parametrization of reirradiation.