title: Stereotactic body radiotherapy as primary therapy for head and neck cancer in the elderly or patients with poor performance.
abstract: OBJECTIVE
  Stereotactic body radiotherapy (SBRT) is increasingly used to treat a variety of tumors, including head and neck squamous cell carcinoma (HNSCC) in the recurrent setting. While there are published data for re-irradiation using SBRT for HNSCC, there are limited data supporting its use as upfront treatment for locally advanced disease.
  
  
  METHODS
  Here, we describe three patients who received SBRT as the primary treatment for their HNSCC along with a review of the current literature and discussion of future pathways.
  
  
  RESULTS
  The three cases discussed tolerated treatment well with manageable acute toxicities and had either a clinical or radiographic complete response to therapy.
  
  
  CONCLUSIONS
  Head and neck squamous cell carcinoma presents a unique challenge in the elderly, where medical comorbidities make it difficult to tolerate conventional radiation, often given with a systemic sensitizer. For these individuals, providing a shortened course using SBRT may offer an effective alternative.
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Arya
authors.initials: A
authors.lastname: Amini
authors.affiliation: Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Jessica D
authors.initials: JD
authors.lastname: McDermott
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Gan
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Whitney
authors.initials: W
authors.lastname: Sumner
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Fisher
authors.affiliation: Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Jimeno
authors.affiliation: Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Bowles
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: David
authors.initials: D
authors.lastname: Raben
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine , Aurora, CO , USA.
authors.forename: Sana D
authors.initials: SD
authors.lastname: Karam
keywords: elderly; head and neck cancer; poor KPS; stereotactic body radiotherapy