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The main objective of our study is to describe the pattern of recurrence in locally advanced head and neck cancer patients treated with chemoradiationat Father Muller Medical College Hospital, Mangalore, India. Thirty patients treated with Loco-regional recurrence chemoradiation were included. Loco-regional failure volume was defined on the planning at relapse, and dose received was analyzed by use of dose–volume histograms. Loco-regional failure was classified as In-field, Marginal or Out-fields.Median interval time from end of treatment to Loco-regional failure was 29months. There were 19 patients with local failure, 8 with a regional failure, and the remaining 3 patients failed simultaneously at both local and regional sites. 26 patients (86.7%) had In-field recurrence, 2(6.7%) patients with Marginal recurrence and 2 (6.7%) patient with Out-field recurrence. Considering primary target volumes, 18 (69.2%) Loco-regional failure occurred inside Gross Tumor Volume (GTV), 5 (19.2%) in Clinical Target Volume (CTV) region and 3 (11.6%) in GTV + CTV region. The majority of Loco-regional failures occurred In-field and precisely within GTV (High dose region). Given the low incidence of geographical misses, future studies should be directed towards additional efforts aimed at improving loco-regional tumour control with radiotherapy.

“Recurrence Following Chemoradiation in Locally Advanced Head and Neck Carcinoma – An Institutional Experience”