Authors: Marina Amorim, Catarina Silva, Sara Simões, Maria Adelina Costa, Graça Fonseca, Cármen Calçada, Joana Vale, Fátima Rodrigues, Paulo Genésio, António Moreira Pinto, André Ferreira, Carla Sousa, Paulo Costa.
Background: Recurrences of head and neck tumors (HNT) are associated with a poor prognosis. Many of these patients have previously undergone radical radiation therapy with dose limitations for critical organs. In this context, re-irradiation may carry an increased risk of complications. The combination of radiotherapy with hyperthermia (RT/HT) has gained importance in these patients due to its complementary tumoricidal effect, allowing for lower radiation doses and a consequent reduction in toxicity. This study aims to describe the experience of our department in treating recurrent HNT with RT/HT and to evaluate its therapeutic impact on early response and quality of life.
Material and Methods: A retrospective study of 12 patients with recurrent HNT treated with RT/HT between March 2019 and July 2021. All patients received the same scheme, consisting of radiotherapy twice a week with a 3-day interval, at a dose of 32 Gy in 8 fractions, and 1 hour of hyperthermia once a week, 30 minutes after the radiotherapy session. Hyperthermia was administered using the CelsiusTCS42 system, a non-invasive capacitive hyperthermia device that emits a radiofrequency of 13.56 MHz, allowing for focal and selective tumor temperature increase.
Results: The median age was 61 years (range 48-89). The most frequent location was the maxillary sinus (4 cases), followed by the larynx (2 cases). In all cases, there was a complete response in terms of pain/bleeding control. Control of infection/necrosis was achieved in 75%, and a complete response was observed in 50% of the patients. The treatment was generally well-tolerated, with no reports of grade ≥ 3 toxicity.
Conclusion: In our study the combination of RT/HT has demonstrated to be a feasible and safe strategy in addressing the recurrence of previously irradiated HNT. In addition to the observed physical impact, there was also a noticeable psychological impact, given the location of the disease in exposed areas related to basic activities of daily living. Further studies will be needed to assess late response, duration of remission and the combination with systemic therapy.
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