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 <14 days was associated with significantly improved recurrence-free survival (RFS) at the expense of increased late toxicity (p = .029). Tumor volume >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.
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 <14 days was associated with significantly improved recurrence-free survival (RFS) at the expense of increased late toxicity (p = .029). Tumor volume >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.
Authors: Diane C Ling; John A Vargo; Rachel J Grimm; Brian J Gebhardt; David A Clump; Robert L Ferris; James P Ohr; Dwight E Heron Journal: J Radiosurg SBRT Date: 2020
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Authors: Diane C Ling; John A Vargo; Brian J Gebhardt; Rachel J Grimm; David A Clump; Robert L Ferris; James P Ohr; Dwight E Heron Journal: J Radiosurg SBRT Date: 2019
Authors: Kara S Davis; John A Vargo; Robert L Ferris; Steven A Burton; James P Ohr; David A Clump; Dwight E Heron Journal: Oral Oncol Date: 2014-08-28 Impact factor: 5.337
Authors: Muhammad Shahid Iqbal; Nick West; Neil Richmond; Josef Kovarik; Isabel Gray; Nick Willis; David Morgan; Gozde Yazici; Mustafa Cengiz; Vinidh Paleri; Charles Kelly Journal: Br J Radiol Date: 2020-09-24 Impact factor: 3.039