Universität zu Köln

Schleifenbaum, Julia Katharina ORCID: 0000-0001-7204-3235, Morgenthaler, Janis ORCID: 0000-0002-7780-2170, Sharma, Shachi Jenny ORCID: 0000-0002-2768-7936, Klußmann, Jens Peter ORCID: 0000-0002-8223-7954, Linde, Philipp ORCID: 0000-0002-2813-1331, Wegen, Simone ORCID: 0000-0002-0361-728X, Rosenbrock, Johannes ORCID: 0000-0003-3340-0556, Baues, Christian ORCID: 0000-0003-1733-6064, Fokas, Emmanouil ORCID: 0000-0003-1601-6165, Khor, Richard ORCID: 0000-0002-7057-2747, Ng, Sweet Ping ORCID: 0000-0003-1721-0680, Marnitz, Simone and Trommer, Maike ORCID: 0000-0003-2864-4273 (2025). Optimising (re-)irradiation for locally recurrent head and neck cancer: impact of dose-escalation, salvage surgery, PEG tube and biomarkers on oncological outcomes—a single centre analysis. Radiation Oncology, 20 (1). pp. 1-12. Springer Nature. ISSN 1748-717X

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Abstract

[Article number 1] Introduction: Locoregional recurrence (LR) is common in locally advanced head and neck cancer (HNSCC), posing challenges for treatment. We analysed outcome parameters and toxicities for patients being treated with radiotherapy (RT) for LR-HNSCC and investigated patient and disease related prognostic factors in this prognostically unfavourable group. Methods: This analysis includes 101 LR-HNSCC patients treated with RT, radio-chemotherapy (RCT) or radio-immunotherapy (RIT) between 2010 and 2018 at a high-volume tertiary centre. Patient characteristics, tumour and treatment details were retrospectively collected. Overall survival (OS), progression-free survival (PFS) and toxicities according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0 were assessed. Results: 62% of patients were radiotherapy-naïve (initial RT group) while 38% were re-irradiated at site of LR (re-RT group). Median OS for initial RT was 24 months, for re-RT 12 months (p < 0.01). In the RCT subgroup, patients with initial RT had significantly longer OS with 35 months compared to re-RT 12 months (p < 0.05). Patients with UICC grade IV tumours and percutaneous endoscopic gastrostomy (PEG) tube had significantly shorter OS in multivariate analysis: initial RT 13 vs. re-RT 32 months and initial RT 12 vs. re-RT 32 months respectively. Salvage surgery before RT at recurrence was a positive prognostic factor for OS (initial RT 35 vs. re-RT 12 months). Other significant factors for longer OS in univariate analysis included low inflammatory status (Glasgow Prognostic Score 0) and radiation doses ≥ 50 Gy. We detected 37 (15%) ≥ CTCAE Grade 3 events for initial RT and 19 (15%) for re-RT patients. Conclusion: In this analysis, we identified key prognostic factors including PEG tube and inflammation status that could guide treatment decision. Our findings suggest salvage surgery as preferred treatment option with postoperative RT at LR. Adverse events due to re-RT were acceptable. A radiation dose of ≥ 50 Gy should be administered to achieve better outcomes.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Schleifenbaum, Julia Katharina UNSPECIFIED https://orcid.org/0000-0001-7204-3235 UNSPECIFIED Morgenthaler, Janis UNSPECIFIED https://orcid.org/0000-0002-7780-2170 UNSPECIFIED Sharma, Shachi Jenny UNSPECIFIED https://orcid.org/0000-0002-2768-7936 UNSPECIFIED Klußmann, Jens Peter UNSPECIFIED https://orcid.org/0000-0002-8223-7954 UNSPECIFIED Linde, Philipp UNSPECIFIED https://orcid.org/0000-0002-2813-1331 UNSPECIFIED Wegen, Simone UNSPECIFIED https://orcid.org/0000-0002-0361-728X UNSPECIFIED Rosenbrock, Johannes UNSPECIFIED https://orcid.org/0000-0003-3340-0556 UNSPECIFIED Baues, Christian UNSPECIFIED https://orcid.org/0000-0003-1733-6064 UNSPECIFIED Fokas, Emmanouil UNSPECIFIED https://orcid.org/0000-0003-1601-6165 UNSPECIFIED Khor, Richard UNSPECIFIED https://orcid.org/0000-0002-7057-2747 UNSPECIFIED Ng, Sweet Ping UNSPECIFIED https://orcid.org/0000-0003-1721-0680 UNSPECIFIED Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Trommer, Maike UNSPECIFIED https://orcid.org/0000-0003-2864-4273 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-793253
Identification Number:	10.1186/s13014-024-02570-y
Journal or Publication Title:	Radiation Oncology
Volume:	20
Number:	1
Page Range:	pp. 1-12
Date:	2 January 2025
Publisher:	Springer Nature
ISSN:	1748-717X
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Centrum für integrierte Onkologie (CIO) Faculty of Medicine > Strahlentherapie > Klinik und Poliklinik für Strahlentherapie
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79325