| Abstract: |
This prospective study is to evaluate the feasibility and efficacy of primary external beam irradiation with regard to radiation induced morbidity , locoregional control and survival among patients with previously irradiated,non-metastatic,locally recurrent or new primary squamous cell carcinoma of the head and neck (SCCHN) This study included 30 patients with Recurrent ( n=22 ) and new primary ( n= 8 ) squamous cell carcinoma of the head and neck, Patients were selected for re-irradiation in case of inoperable , unresectable tumors or refuse surgery. All patients were treated in Clinical Oncology Department, Zagazig University Hospital between April 2010 and June 2011 by Conformal Reirradiation .• Treatment prtocol:All patients were treated by 3D Conformal Radiotherapy with a dose 50 Gy with 1.8- 2 Gy single daily fraction , 5 fraction per week over 5 weeks.Patients were seen weekly during treatment for assessment of early tissue reactions. Subsequently patients were examined monthly during period of follow up. C.T. scan and endoscopy were done one month after the end of treatment to assess for response and repeated every three months to assess for progression.The recorded data from thirty patients who completed the procedure of the study have been collected, statistically analyzed , and presented at the end of the treatment . the overall response rate ( CR + PR ) was 87 % of which Complete response (CR) was recorded in 56 % while partial response (PR) was 31 % .• The results were analyzed according to some prognostic variables :AgeThe age ranged between 25-69 years, with mean age of 52.3 years.:Sex:The majority of patients were males, with male to female ratio of 1.5:1, males constitutes 18 of patients (60%), females were 12of patients (40%).Performance status:There were 21 patients ( 70%) with ECOG scale of ( grade 2) and 9 patients (30%) were grade 2 - 3Histological grade:All patients had squamous cell carcinoma most of them presented with grade II; 15/30 (50%) and grade III; 12/30 (40%).Staging :tumor staging , represent all patients( Recurrent + 2nd Primary ) According to TNM AJCC staging system 2010.Also according to Initial primary site, Initial treatment protocol, Iniyial dose of radiation, Site of recurrent, and Duration between initial RT and ReRT.CONCLUSIONThere is a better chance to improve the response rate with the use ofprimary external beam irradiation with regard to radiation induced morbidity ,in locoregional control and survival among patients with previously irradiated,non-metastatic,locally recurrent or new primary squamous cell carcinoma of the head and neck (SCCHN).This prospective study is to evaluate the feasibility and efficacy of primary external beam irradiation with regard to radiation induced morbidity , locoregional control and survival among patients with previously irradiated,non-metastatic,locally recurrent or new primary squamous cell carcinoma of the head and neck (SCCHN) This study included 30 patients with Recurrent ( n=22 ) and new primary ( n= 8 ) squamous cell carcinoma of the head and neck, Patients were selected for re-irradiation in case of inoperable , unresectable tumors or refuse surgery. All patients were treated in Clinical Oncology Department, Zagazig University Hospital between April 2010 and June 2011 by Conformal Reirradiation .• Treatment prtocol:All patients were treated by 3D Conformal Radiotherapy with a dose 50 Gy with 1.8- 2 Gy single daily fraction , 5 fraction per week over 5 weeks.Patients were seen weekly during treatment for assessment of early tissue reactions. Subsequently patients were examined monthly during period of follow up. C.T. scan and endoscopy were done one month after the end of treatment to assess for response and repeated every three months to assess for progression.The recorded data from thirty patients who completed the procedure of the study have been collected, statistically analyzed , and presented at the end of the treatment . the overall response rate ( CR + PR ) was 87 % of which Complete response (CR) was recorded in 56 % while partial response (PR) was 31 % .• The results were analyzed according to some prognostic variables :AgeThe age ranged between 25-69 years, with mean age of 52.3 years.:Sex:The majority of patients were males, with male to female ratio of 1.5:1, males constitutes 18 of patients (60%), females were 12of patients (40%).Performance status:There were 21 patients ( 70%) with ECOG scale of ( grade 2) and 9 patients (30%) were grade 2 - 3Histological grade:All patients had squamous cell carcinoma most of them presented with grade II; 15/30 (50%) and grade III; 12/30 (40%).Staging :tumor staging , represent all patients( Recurrent + 2nd Primary ) According to TNM AJCC staging system 2010.Also according to Initial primary site, Initial treatment protocol, Iniyial dose of radiation, Site of recurrent, and Duration between initial RT and ReRT.CONCLUSIONThere is a better chance to improve the response rate with the use ofprimary external beam irradiation with regard to radiation induced morbidity ,in locoregional control and survival among patients with previously irradiated,non-metastatic,locally recurrent or new primary squamous cell carcinoma of the head and neck (SCCHN).This prospective study is to evaluate the feasibility and efficacy of primary external beam irradiation with regard to radiation induced morbidity , locoregional control and survival among patients with previously irradiated,non-metastatic,locally recurrent or new primary squamous cell carcinoma of the head and neck (SCCHN).
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