Source: www.modernmedicine.com
Author: staff

For some patients, reirradiation of recurrent head and neck cancer can extend life. But for those with comorbidities or organ dysfunction, such as feeding tube dependence, it is likely to offer only palliative support, according to a report in the March 16 issue of the Journal of Clinical Oncology.

Tawee Tanvetyanon, M.D., of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., and colleagues reviewed medical records of 103 patients with head and neck cancer who received reirradiation at the center between 1998 and 2008. In an effort to determine prognostic factors for success, researchers analyzed the data using both the Charlson index and Adult Comorbidity Evaluation-27 (ACE-27).

The investigators found significant comorbidity in 36 percent of the study group with the Charlson index and 24 percent with the ACE-27; organ dysfunction occurred in 37 percent of patients. For patients with both organ dysfunction and comorbidity, median overall survival was 5.5 months (Charlson) and 4.9 months (ACE-27). This compared with 59.6 months (Charlson) and 44.2 months (ACE-27) for patients who did not have either organ dysfunction or comorbidity, the researchers report. Lesser prognostic factors were stage of recurrent tumor, tumor size and reirradiation dose.

“For patients with favorable risk factors, reirradiation should be strongly considered as it offers the promise of long-term survival. For patients with poor risk factors, however, such promise is unlikely,” the authors write.