Headstrong.

Head and neck reirradiation is an attractive use of proton therapy. Here is a look at outcomes for 242 patients receiving proton reirradiation at MSKCC for recurrent or second head and neck squamous cell carcinoma (HNSCC). Median time interval to reirradiation was 22 months, and roughly two-thirds received fractionated reirradiation with the remaining one-third receiving a more palliative quad shot regimen. Local control at one year after fractionated reirradiation was 72% and overall survival 67%. Local control after quad shot was similar at 62%, but overall survival was low (29%), as expected given patient selection. Overall, these rates are encouraging but came at the cost of acute grade 4 dysphagia (n=2) and dermatitis (n=4), late grade 4 dysphagia (n=1) and dermatitis (n=3) as well as a umber of potentially treatment-related grade 5 bleeding events (n=5). | Lee, JAMA Netw Open 2023