Head and neck cancer in young adults treated with 3-D conformal radiotherapy

Background: Purpose of this study was to determine patterns of failure in young adults with head and neck cancer treated with 3-D conformal radiotherapy. Methods: Twenty-eight patients with head and neck cancer younger than 41 years of age were treated with 3-D conformal radiotherapy. Patients’ median age was 31.4 years. Radiotherapy was delivered in the median total dose of 67.2 Gy to PTV (range, 60.0-70.0 Gy) with or without concurrent cisplatin. Results: The median duration of follow-up was 20 months. Distant metastases were the most frequent pattern of failure. The locoregional relapse-free survival (LRR-FS) rate at 2 years was 66.6%. The median duration of LRR-FS was 15 months. The distant metastases relapse-free survival (DMR-FS) rate at 2 years was 65.7%. The median duration of DMR-FS was also 15 months. The overall survival (OS) rate at 2 years was 57.2%. The median duration of OS was 20 months. Conclusion: Radiotherapy with or without concurrent chemotherapy plays an important role in treatment of patients with head and neck cancer. Recent developments of new radiotherapy techniques have increased rates of local control. Distant metastases remain the most frequent pattern of failure in this group of young adults with head and neck cancer. Introducing new cytotoxic and target therapies in future could lead to better outcome in this subgroup of patients.