Head and Neck Tumor Control Probability: Radiation Dose-Volume Effects in SBRT for Locally-Recurrent Previously-Irradiated Head and Neck Cancer

Publication date: Available online 31 January 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): John A. Vargo, Vitali Moiseenko, Jimm Grimm, Jimmy Caudell, David A. Clump, Ellen Yorke, Jinyu Xue, Yevgeniy Vinogradskiy, Eduardo G. Moros, Panayiotis Mavroidis, Sheena Jain, Issam El Naqa, Lawrence B. Marks, Dwight E. Heron
Stereotactic Body Radiotherapy (SBRT) as emerged as a viable re-irradiation strategy for locally-recurrent previously-irradiated head-and-neck cancer. Doses in the literature have varied which challenges clinical application of SBRT as well as clinical trial design. A working group was formed through the American Association of Physicists in Medicine to study tumor control probabilities for SBRT in head and neck cancer. We herein present a systematic review of the available literature addressing the dose/volume data for tumor control probability with SBRT in patients with locally-recurrent previously-irradiated head and neck cancer. Dose response models are generated that present tumor control probability as a function of dose. Data from over 300 cases in 8 publications suggests that there is a dose-response relationship with superior local control and possibly improved overall survival, for doses of 35-45Gy (in 5 fractions) compared to <30 Gy. SBRT doses equivalent to 5 fraction doses of 40-50Gy are suggested for re-treatment.

Teaser

In a systematic review of the available literature addressing the dose/volume data for tumor control probability with SBRT in patients with locally-recurrent previously-irradiated head-and-neck cancer, data from over 300 cases in 8 publications suggests that there is a dose-response relationship with superior local control and possibly improved overall survival, for doses of 35-45Gy (in 5 fractions) compared to <30 Gy. SBRT doses equivalent to 5 fraction doses of 40-50Gy are suggested for re-treatment.


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