Stereotactic body ablative radiotherapy for reirradiation of small volume head and neck cancers is associated with prolonged survival: Large, single‐institution, modern cohort study
Kevin Diao, Theresa Nguyen, Amy C. Moreno, Jay P. Reddy, Adam S. Garden, Catherine H. Wang, Samuel Tung, Congjun Wang, Xin A. Wang, David I. Rosenthal, Clifton D. Fuller, Gary B. Gunn, Steven J. Frank, William H. Morrison, Shalin Shah, Anna Lee, Michael T. Spiotto, Shirley Y. Su, Renata Ferrarotto, Jack Phan
Abstract
BACKGROUND: Recurrent head and neck cancer has poor prognosis. Stereotactic body radiotherapy (SBRT) may improve outcomes by delivering ablative radiation doses. METHODS: We reviewed patients who received definitive-intent SBRT reirradiation at our institution from 2013 to 2020. Patterns of failure, overall survival (OS), and toxicities were analyzed. RESULTS: One hundred and thirty-seven patients were evaluated. The median OS was 44.3 months. The median SBRT dose was 45 Gy and median target volume 16.9 cc. The 1-year local, regional, and distant control was 78%, 66%, and 83%, respectively. Systemic therapy improved regional (p = 0.004) and distant control (p = 0.04) in nonmetastatic patients. Grade 3+ toxicities were more common at mucosal sites (p = 0.001) and with concurrent systemic therapy (p = 0.02). CONCLUSIONS: In a large cohort of SBRT reirradiation for recurrent, small volume head and neck cancers, a median OS of 44.3 months was observed. Systemic therapy improved regional and distant control. Toxicities were modulated by anatomic site and systemic therapy.