Revisiones en Cáncer 00061 / http://dx.doi.org/10.20960/revcancer.00061
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Revisión

Papel de la radioterapia y de la reirradiación en las recidivas y la enfermedad metastásica


Fernando Puebla Díaz, Raquel Benlloch Rodríguez

Prepublicado: 2024-03-21

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La recidiva locorregional es el principal patrón de fallo en los tumores de cabeza y cuello. En los pacientes que recidivan tras un tratamiento radioterápico, las opciones de tratamiento son limitadas. El rescate quirúrgico es el tratamiento de elección en recidivas localizadas en áreas previamente irradiadas o segundas neoplasias operables. La reirradiación posoperatoria puede valorarse en pacientes con alto riesgo de recidiva local. La reirradiación radical es una opción de tratamiento en pacientes inoperables o que rechazan la cirugía de rescate. El volumen de reirradiación debe ser limitado para minimizar los efectos secundarios. La dosis de reirradiación ≥ 50-60 Gy puede mejorar el control local, pero conlleva un aumento del riesgo de complicaciones graves agudas y tardías. Las nuevas técnicas de irradiación pueden mejorar el control local y reducir la toxicidad de la reirradiación.

Palabras Clave: Cáncer de cabeza y cuello. Recidiva locorregional. Segundo tumor primario. Reirradiación. Toxicidades.



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