Toxicities Following Stereotactic Ablative Radiotherapy Treatment of Locally-Recurrent and Previously Irradiated Head and Neck Squamous Cell Carcinoma
Toxicities Following Stereotactic Ablative Radiotherapy Treatment of Locally-Recurrent and Previously Irradiated Head and Neck Squamous Cell Carcinoma
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DOI：
10.1016/j.semradonc.2015.11.007
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发表时间：
2016-04-01
影响因子：
3.5
通讯作者：
Heron, Dwight E.
中科院分区：
文献类型：
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作者：
Quan, Kimmen;Xu, Karen M.;Heron, Dwight E.
立体定向消融放疗（SABR）联合西妥昔单抗是治疗既往接受过放疗的局部复发性头颈部鳞状细胞癌的有效治疗选择，其局部控制率和总生存率与其他治疗方案相似。每次再治疗在很大程度上取决于之前的治疗，每个患者都是特殊情况。根据我们机构的经验和先前发表的研究，对于接受西妥昔单抗合并治疗且既往放疗中位剂量为70戈伊的患者，我们建议总剂量为40-44戈伊，分5次给药，隔日给药，持续1-2周。然而，2级或3级毒性并不罕见。因此，在这篇综述中，我们还报告了一项试点研究，应用正常组织并发症概率剂量反应模型，以估计局部复发性鳞状细胞癌的头部和颈部再照射SABR的毒性概率。尽管该剂量-反应模型包括了同时进行的靶向治疗，但对于没有靶向治疗的SABR，还没有类似的模型，但没有同时进行生物治疗或化疗的并发症发生率不应高于本文所述的并发症发生率。(C)2016 Elsevier Inc. All rights reserved.
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. (C) 2016 Elsevier Inc. All rights reserved.