Radiochemotherapy with paclitaxel for recurrent previously irradiated squamous cell carcinoma of the head and neck

Background/Aim: Locoregional recurrences of squamous cell carcinoma of the head and neck (SCCHN) are difficult to treat. If radiotherapy was included in the primary treatment, another curative course of radiotherapy incurs substantial risk of complications. Results of re-irradiation can be improved by concurrent chemotherapy. Patients and Methods: Radiotherapy with low doses per fraction twice daily and paclitaxel were applied in four patients with recurrent SCCHN. Radiotherapy was administered with doses of 30-36 Gy and doses per fraction of 1.5 Gy twice daily. Concurrent chemotherapy consisted of 20-25 mg/m2 paclitaxel twice per week. Overall 1-year locoregional control following re-irradiation was 25%. One-year locoregional control rates were 75% inside the re-irradiated region and 50% outside the re-irradiated region. Distant metastases did not occur. One-year overall survival following re-irradiation was 75%. Toxicity did not exceed grade 2. Conclusion: Re-irradiation plus concurrent paclitaxel appeared well-tolerated and resulted in promising outcomes.