Stereotactic body radiotherapy for recurrent squamous cell carcinoma of the head and neck: results of a phase I dose-escalation trial.
OBJECTIVE
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).


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 [(18)F]-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.


CONCLUSIONS
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.
Heron
Dwight E
DE
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15232, USA. herond2@upmc.edu
Ferris
Robert L
RL
Karamouzis
Michalis
M
Andrade
Regiane S
RS
Deeb
Erin L
EL
Burton
Steven
S
Gooding
William E
WE
Branstetter
Barton F
BF
Mountz
James M
JM
Johnson
Jonas T
JT
Argiris
Athanassios
A
Grandis
Jennifer R
JR
Lai
Stephen Y
SY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D011832:Radiation Injuries / Q000473:pathology; D019275:Radiopharmaceuticals; D016634:Radiosurgery / Q000009:adverse effects* / Q000379:methods; D011879:Radiotherapy Dosage; D012074:Remission Induction; D019233:Retreatment; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden / Q000528:radiation effects
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18