AN INSTITUTIONAL STUDY TO EVALUATE THE EFFICACY AND TOXICITY OF REIRRADIATION USING CONVENTIONAL RADIOTHERAPY FOR RECURRENT MALIGNANT DISEASE.

Corresponding Author:
Dr. Arpit Jain,
3rd Year Postgraduate Student,
Department of Radiation Oncology,
Government Cancer Hospital, MGMMC,
Indore, Madhya Pradesh, India.
E-mail: arpitjain8390@gmail.com

ABSTRACT

BACKGROUND

Locoregional failure is the most frequent pattern of failure in various cancer patients despite intensified treatment and it leads to death in most of the patients. Traditionally, surgery as salvage therapy for locoregional recurrence provides the greatest probability of cure; unfortunately, the vast majority of locoregional recurrent cases are unresectable. Although chemotherapy has been the standard of care for patients who are not candidates for surgery, the response rates are limited. Reirradiation is a potentially curative or best palliative treatment option for some patients with unresectable disease. This study reported our experience of reirradiation alone or concurrent chemoradiotherapy in recurrent malignant condition.

MATERIALS AND METHODS

We reviewed 26 consecutive patients with a diagnosis of locoregional recurrences (LRR) of Head and Neck, Cervix, Urinary Bladder, CNS carcinoma treated with a second course of radiotherapy. The main outcome measures were local control, overall survival, and complications.

RESULTS

Efficacy and toxicity were scored by looking at the reduction in tumour size, pain and bleeding. Reduction in tumour size and pain reduction after reirradiation were seen in 100% and 95% of the patients respectively. In 95% of the cervical carcinoma patients there was a reduction in bleeding. The 1-year local control rate for the whole group was 64%. Symptomatic response was observed in 96% of the patients. No grades 5, 4 and 3 acute and late toxicity was observed.

CONCLUSION

Continuous course reirradiation in patients with LRR in various carcinoma is feasible with acceptable toxicity. With current encouraging rates of local control and overall survival, this option should be discussed with patients who have few alternative therapeutic options.

KEY WORDS

Reirradiation, Recurrent, Radiation.