Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer: A multi-institutional study of AIRO—Head and Neck working group

Orlandi, E.; Bonomo, P.; Ferella, L.; D'Angelo, E.; Maddalo, M.; Alterio, D.; Infante, G.; Bacigalupo, A.; Argenone, A.; Iacovelli, N. A.; Desideri, I.; Meduri, B.; Triggiani, L.; Volpe, S.; Belgioia, L.; Dionisi, F.; Romanello, D. A.; Fallai, C.; Miceli, R.

doi:10.1002/hed.25890

Background: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. Methods: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. Results: Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. Conclusion: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.

Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer: A multi-institutional study of AIRO—Head and Neck working group

Orlandi E.;Bonomo P.;Ferella L.;D'Angelo E.;Maddalo M.;Alterio D.;Infante G.;Bacigalupo A.;Argenone A.;Iacovelli N. A.;Desideri I.;Meduri B.;Triggiani L.;Volpe S.;Belgioia L.;Dionisi F.;Romanello D. A.;Fallai C.;Miceli R.

2019-01-01

Abstract

Background: To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. Methods: We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. Results: Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm3 were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. Conclusion: Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.