Toxicities Following Stereotactic Ablative Radiotherapy Treatment of Locally-Recurrent and Previously Irradiated Head and Neck Squamous Cell Carcinoma

Stereotactic ablative radiotherapy (SABR) with concomitant cetuximab is an effective treatment option for previously irradiated, locally recurrent squamous cell carcinoma of the head and neck. Its local control and overall survival are similar to those of other available treatment options. Each retr...

Full description

Saved in:

Bibliographic Details
Published in:	Seminars in radiation oncology 2016-04, Vol.26 (2), p.112-119
Main Authors:	Quan, Kimmen, MD, FRCPC, Xu, Karen M., BS, Zhang, Yongqian, PhD, Clump, David A., MD, PhD, Flickinger, John C., MD, Lalonde, Ron, PhD, Burton, Steven A., MD, Heron, Dwight E., MD, MBA, FACRO, FACR
Format:	Article
Language:	eng
Subjects:	Aged Aged, 80 and over Antineoplastic Agents - therapeutic use Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - radiotherapy Cetuximab - therapeutic use Combined Modality Therapy Dose-Response Relationship, Radiation Female Head and Neck Neoplasms - drug therapy Head and Neck Neoplasms - radiotherapy Hematology, Oncology and Palliative Medicine Humans Male Middle Aged Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - radiotherapy Pilot Projects Radiation Injuries - epidemiology Radiology Radiosurgery - adverse effects Radiosurgery - statistics & numerical data Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Retreatment Treatment Outcome
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Stereotactic ablative radiotherapy (SABR) with concomitant cetuximab is an effective treatment option for previously irradiated, locally recurrent squamous cell carcinoma of the head and neck. Its local control and overall survival are similar to those of other available treatment options. Each retreatment depends heavily on the prior treatment and every patient is a special case. Based on the experience of our institution and previously published studies, for patients who receive concomitant cetuximab with a median prior radiation therapy dose of 70 Gy, we recommend a total dose of 40-44 Gy delivered in 5 fractions on alternating days over 1-2 weeks. However, Grade 2 or 3 toxicities are not uncommon. Therefore, in this review, we also report a pilot study that applies a normal tissue complication probability dose-response model to estimate the probability of toxicities in locally recurrent squamous cell carcinoma of the head and neck reirradiated with SABR. Although this dose-response model includes concurrent targeted therapy and no comparable model yet exists for SABR without it, complication rates without concurrent biological therapy or chemotherapy should be no higher than those described here.
ISSN:	1053-4296 1532-9461