title: Stereotactic body radiation therapy for locally recurrent, previously irradiated nonsquamous cell cancers of the head and neck.
abstract: BACKGROUND
  Stereotactic body radiotherapy (SBRT) has emerged as a promising salvage strategy for patients with recurrent, previously irradiated head and neck cancer; however, data are limited predominantly to squamous cell carcinomas. Herein, we report the efficacy of SBRT in recurrent, nonsquamous cell cancers of the head and neck (NSCHNs).
  
  
  METHODS
  In all, 34 patients with pathologically proven NSCHN were re-irradiated with SBRT to a median dose of 40 Gy in 5 fractions (interquartile range, 30-44 Gy). Toxicity and quality of life were followed prospectively.
  
  
  RESULTS
  Median follow-up was 10 months (absolute range, 0-55 months). The 6-month/1-year local control rate was 77/59%, with a 6-month/1-year overall survival of 76/59%. Local control was significantly improved for tumors <25 mL (p = .030). Acute/late grade 3 toxicity was 15/6%, with no grade 4-5 toxicity.
  
  
  CONCLUSIONS
  SBRT for previously irradiated, locally recurrent NSCHN provides promising local control, especially for tumors <25 mL, with minimal toxicity. The optimal dose for larger tumors remains to be defined.
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Vargo
authors.forename: Rodney E
authors.initials: RE
authors.lastname: Wegner
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Heron
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.forename: Jean-Claude M
authors.initials: JC
authors.lastname: Rwigema
authors.forename: Annette
authors.initials: A
authors.lastname: Quinn
authors.forename: Patricia
authors.initials: P
authors.lastname: Gigliotti
authors.forename: James
authors.initials: J
authors.lastname: Ohr
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Kubicek
authors.forename: Steven
authors.initials: S
authors.lastname: Burton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology; D004408:Dysgeusia / Q000209:etiology; D004487:Edema / Q000209:etiology; D018304:Esthesioneuroblastoma, Olfactory / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D052016:Mucositis; D064847:Multimodal Imaging; D009208:Myoepithelioma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D010020:Osteonecrosis / Q000209:etiology; D010146:Pain / Q000209:etiology; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011788:Quality of Life; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D012371:Robotics; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014987:Xerostomia / Q000209:etiology