Stereotactic body radiation therapy for locally recurrent, previously irradiated nonsquamous cell cancers of the head and neck

Head Neck. 2012 Aug;34(8):1153-61. doi: 10.1002/hed.21889. Epub 2011 Nov 11.

Abstract

Background: Stereotactic body radiotherapy (SBRT) has emerged as a promising salvage strategy for patients with recurrent, previously irradiated head and neck cancer; however, data are limited predominantly to squamous cell carcinomas. Herein, we report the efficacy of SBRT in recurrent, nonsquamous cell cancers of the head and neck (NSCHNs).

Methods: In all, 34 patients with pathologically proven NSCHN were re-irradiated with SBRT to a median dose of 40 Gy in 5 fractions (interquartile range, 30-44 Gy). Toxicity and quality of life were followed prospectively.

Results: Median follow-up was 10 months (absolute range, 0-55 months). The 6-month/1-year local control rate was 77/59%, with a 6-month/1-year overall survival of 76/59%. Local control was significantly improved for tumors <25 mL (p = .030). Acute/late grade 3 toxicity was 15/6%, with no grade 4-5 toxicity.

Conclusions: SBRT for previously irradiated, locally recurrent NSCHN provides promising local control, especially for tumors <25 mL, with minimal toxicity. The optimal dose for larger tumors remains to be defined.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / surgery
  • Deglutition Disorders / etiology
  • Dysgeusia / etiology
  • Edema / etiology
  • Esthesioneuroblastoma, Olfactory / mortality
  • Esthesioneuroblastoma, Olfactory / pathology
  • Esthesioneuroblastoma, Olfactory / surgery
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mucositis
  • Multimodal Imaging
  • Myoepithelioma / mortality
  • Myoepithelioma / pathology
  • Myoepithelioma / surgery
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery*
  • Osteonecrosis / etiology
  • Pain / etiology
  • Positron-Emission Tomography
  • Prospective Studies
  • Quality of Life
  • Radiosurgery*
  • Radiotherapy Dosage
  • Robotics
  • Sarcoma / mortality
  • Sarcoma / pathology
  • Sarcoma / surgery
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Xerostomia / etiology