Examining tumor control and toxicity after stereotactic body radiotherapy in locally recurrent previously irradiated head and neck cancers: Implications of treatment duration and tumor volume

• Published in: Head & neck 2014-09, Vol.36 (9), p.1349-1355
• Main Authors: Vargo, John A., Heron, Dwight E., Ferris, Robert L., Rwigema, Jean-Claude M., Kalash, Ronny, Wegner, Rodeny E., Ohr, James, Burton, Steven
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Agents - therapeutic use; Cetuximab; Female; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Humans; Male; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Patient Selection; Radiosurgery; reirradiation head and neck; Retrospective Studies; Risk Factors; stereotactic body radiation therapy (SBRT); Treatment Outcome; treatment time; Tumor Burden; tumor volume
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.23462

Background Stereotactic body radiotherapy (SBRT) has been studied in locally recurrent previously‐irradiated head and neck cancers; however, the optimum fractionation and patient selection continues to be defined. Methods Patients (n = 132) with locally recurrent head and neck cancer salvaged via SBRT ± cetuximab (median, 44 Gy/5 fractions) from November 2004 to May 2011 were retrospectively reviewed. Disease outcomes and toxicity were analyzed by predictive factors including treatment duration and tumor volume. Results At a median 6‐month follow‐up (range, 0–55 months), treatment duration 25 cc remained a significant predictor of inferior survival and tumor control, and was associated with significantly more acute toxicity (p = .017) but no difference in late toxicity. Conclusion SBRT ± cetuximab achieves promising tumor control and survival with low rates of acute/late toxicity even for recurrences >25 cc. Prolongations in treatment time may decrease late toxicity at the expense of disease control. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1349–1355, 2014