title: Stereotactic body radiation therapy for primary, recurrent, and metastatic tumors in the head-and-neck region.
abstract: OBJECTIVE
  To determine the feasibility, safety, and efficacy of stereotactic body radiation therapy (SBRT), also known as radiosurgery, in patients with head-and-neck cancers.
  
  
  METHODS
  Patients with pathologically proven malignant lesions in the head-and-neck region were treated using single-dose SBRT (S-SBRT) or fractionated SBRT (F-SBRT). Radiation doses were either single-fraction 13-18 Gy for S-SBRT or 36-48 Gy in five to eight fractions for F-SBRT. Response evaluation was based on clinical examinations and computed tomography/magnetic resonance imaging scans. Pre- and post-SBRT tumor dimensions were measured in three axes, and tumor volumes were calculated. Response evaluation also was performed using World Health Organization criteria.
  
  
  RESULTS
  Fifty-five lesions were treated in 44 patients (25 men, 19 women). There were three groups of patients: those with primary (n = 10), recurrent (n = 21), and metastatic tumors (n = 13). The predominant histologic type was squamous cell carcinoma (n = 33). The majority of lesions were treated using F-SBRT (n = 37). Based on radiographic and clinical assessment, a 77% (complete + partial response) response rate was noted. Percentage of reduction in tumor volume was 52% +/- 38% based on follow-up scans in 24 patients. Tumor control rates at 1 year were 83.3% and 60.6% in the primary and recurrent groups, respectively. Median overall survival was 28.7, 6.7, and 5.6 months for the primary, recurrent, and metastatic groups, respectively. Radiation Therapy Oncology Group Grade 1-2 mucositis was noted in all patients treated for oropharyngeal or laryngeal lesions.
  
  
  CONCLUSIONS
  The SBRT in single or fractionated doses offers a viable treatment option for selected patients with primary, recurrent, and metastatic head-and-neck cancers with functional preservation.
authors.affiliation: Department of Radiation Oncology, Henry Ford Health System, Detroit, MI 48202, USA.
authors.forename: Farzan
authors.initials: F
authors.lastname: Siddiqui
authors.forename: Mehul
authors.initials: M
authors.lastname: Patel
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Khan
authors.forename: Scott
authors.initials: S
authors.lastname: McLean
authors.forename: Jadranka
authors.initials: J
authors.lastname: Dragovic
authors.forename: Jian-Yue
authors.initials: JY
authors.lastname: Jin
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
authors.forename: Samuel
authors.initials: S
authors.lastname: Ryu