Hyperfractionated or accelerated hyperfractionated re-irradiation with ≥42 Gy in combination with paclitaxel for secondary/recurrent head-and-neck cancer

Background/Aim: Patients with secondary/ recurrent squamous cell head and neck cancer (SCCHN) have poor prognoses. Outcomes of re-irradiation with ≥42 Gy plus paclitaxel for secondary/recurrent SCCHN are herein presented. Patients and Methods: Two patients re-irradiated for secondary/recurrent SCCHN were evaluated. Patients received 44.4 Gy (2×1.2 Gy/day) or 42.0 Gy (2×1.5 Gy/day), respectively, plus concurrent paclitaxel (35 mg/m² weekly or 20 mg/m² twice per week). Results: One patient developed a locoregional recurrence and additional metastases at 12 months after re-irradiation and died at 13 months. The other patient developed multiple bone metastases at 103 months and died at 104 months. Acute toxicities included grade 2 anemia and mucositis in both patients. Radiation dermatitis was grade 2 in one patient and grade 3 in the other. Conclusion: Re-irradiation with 42.0-44.4 Gy given twice daily plus paclitaxel was well tolerated and achieved a favorable response. The results need to be confirmed in a prospective trial.