title: Local ablative treatments of oligometastases from head and neck carcinomas.
abstract: BACKGROUND
  Median survival for recurrent/metastatic (unknown poly/oligometastatic status) head and neck cancer patients (HNSCC) is ten months with best systemic treatment. Metastatic ablation shows promising results in selected patients with several tumor types. We aimed to assess the role of surgery and stereotactic ablative body radiotherapy (SABR) with respect to survival in HNSCC.
  
  
  METHODS
  Published data on metastatic HNSCC treated ablatively were analyzed.
  
  
  RESULTS
  Five-year survival rates after pulmonary/liver metastasectomy exceed 20% in selected patients. Two-year survival after lung SABRT of metastasectomy yields 35%. Interesting data on survival and tolerance are reported in other metastatic sites.
  
  
  CONCLUSIONS
  Surgery yields the best level of evidence. However, non-invasive SABR is efficient and well-tolerated in lung/liver, bone and other metastatic locations. Systemic treatment may be given sequentially with ablative treatments, or omitted in well-identified situations. Proper patient selection for local ablative treatment and optimal therapeutic sequence should be assessed in randomized trials.
authors.affiliation: Service de Radiothérapie, Centre Fran¸cois Baclesse, Avenue Général Harris, 14076, Caen, France.
authors.forename: C
authors.initials: C
authors.lastname: Florescu
authors.affiliation: Centre Antoine Lacassagne - Université de Nice Sophia Antipolis, 227 Av de la lanterne, 06200, Nice, France. Electronic address: jthariat@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Thariat
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy*
keywords: Head and neck cancer; Isolated; Limited; Local treatment; Metastasectomy; Metastases; Metastasis; SBRT); Stereotactic irradiation (SABR; Surgery