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Head & neck
•
Head & neck reirradiation:
selection criteria
•
Treatment
related considerations
•
Previous treatment plan: previous dose in area of recurrence ≤50Gy
preferred (≥60-70Gy higher risk)
•
CTV = GTV + margin
•
Re-irradiation dose:
•
≥ 60Gy to achieve more local control
•
Critical structures:
•
Spinal cord: do not exceed 50Gy (total cumulative dose)
•
No cases of myelopathy if cumulative doses ≤60Gy in 2Gy equivalent
doses
•
Brachytherapy for small recurrences in oral cavity and oropharynx
•
IMRT or SBRT to reduce treatment-related toxicity
31
Cacicedo Cancer Treatment Reviews 2014
Head & neck
•
Head & neck reirradiation:
selection criteria
•
General
considerations
•
Treatment decision in multidisciplinary team
•
Consider including patient in clincial trial if possible
32
Cacicedo Cancer Treatment Reviews 2014