Basic Clinical Radiobiology 2017

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

Cacicedo Cancer Treatment Reviews 2014