What dose and fractionation do you use in the setting of head and neck reirradiation?

We have traditionally treated recurrent HNC with full standard fractionated RT concurrent with chemo. In recent years we have transitioned to SBRT, typically 40 Gy in 5 fractions. The use of SBRT is more convenient; current data suggest that both methods achieve similar tumor control rates and simil...

64.8 Gy at 1.2 Gy BID with weekly cisplatin 30 mg/M2.

This is such a broad area that no one particular dosing schedule can be utilized for all cases. With re-treatment it is extremely important to limit the radiation exposure to normal tissue while attempting to deliver a substantial dose to the new [recurrent] tumor volume.

Treatment energy/modality. ...

We utilize hyperfractionation, standard fractionation and SBRT in our practice based on tumor location, tumor volume, time interval to prior RT, and prior RT volumes. For small volume nodal, skull base or nasopharyngeal recurrences, we do SBRT similar to the Pittsburg regimen with concurrent Cetuxim...

We examined these questions in the setting of a multi-institutional retrospective analysis. Short version is that for gross disease there seems to be a benefit for 66+ Gy. Altered fractionation did not seem to improve results, though this was in the context of ~80% of patients receiving concurrent s...

The question is specific to radiotherapy, but I thought that the mention of immunotherapy is pertinent.

Our patients are primarily getting immunotherapy for recurrent head and neck cancer. The results are pretty good and better than seen in publications.

I wonder if others have this experience.