Stereotactic Body Radiotherapy for Recurrent Squamous Cell Carcinoma of the Head and Neck: Results of a Phase I Dose-Escalation Trial

Dwight E. Heron, Robert L. Ferris, Michalis Karamouzis, Regiane S. Andrade, Erin L. Deeb, Steven Burton, William E. Gooding, Barton F. Branstetter, James M. Mountz, Jonas T. Johnson, Athanassios Argiris, Jennifer R. Grandis, Stephen Y. Lai

Research output: Contribution to journalArticle

113 Scopus citations

Abstract

Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) in previously irradiated patients with squamous cell carcinoma of the head and neck (SCCHN). Patients and Methods: In this Phase I dose-escalation clinical trial, 25 patients were treated in five dose tiers up to 44 Gy, administered in 5 fractions over a 2-week course. Response was assessed according to the Response Evaluation Criteria in Solid Tumors and [18F]-fluorodeoxyglucose standardized uptake value change on positron emission tomography-computed tomography (PET-CT). Results: No Grade 3/4 or dose-limiting toxicities occurred. Four patients had Grade 1/2 acute toxicities. Four objective responses were observed, for a response rate of 17% (95% confidence interval 2%-33%). The maximum duration of response was 4 months. Twelve patients had stable disease. Median time to disease progression was 4 months, and median overall survival was 6 months. Self-reported quality of life was not significantly affected by treatment. Fluorodeoxyglucose PET was a more sensitive early-measure response to treatment than CT volume changes. Conclusion: Reirradiation up to 44 Gy using SBRT is well tolerated in the acute setting and warrants further evaluation in combination with conventional and targeted therapies.

Original languageEnglish (US)
Pages (from-to)1493-1500
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume75
Issue number5
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Keywords

  • Head-and-neck cancer
  • Head-and-neck squamous cell carcinoma
  • PET-CT
  • Reirradiation
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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