A Prospective Phase 2 Trial of Reirradiation With Stereotactic Body Radiation Therapy Plus Cetuximab in Patients With Previously Irradiated Recurrent Squamous Cell Carcinoma of the Head and Neck

Single Fraction Stereotactic Radiosurgery for Retreatment of Skull Base Recurrent Head and Neck Malignancies

“…The one-year LC rate was 52.7% with one-year OS of 81.9% and median survival of 25.4 months, which are comparable to other SRS series (Table 2) [10-12, 20-22]. OS was negatively associated with squamous cell histology, but this histology was not significantly associated with local progression after SRS, highlighting the need for effective systemic therapies for such patients.…”

“…OS was negatively associated with squamous cell histology, but this histology was not significantly associated with local progression after SRS, highlighting the need for effective systemic therapies for such patients. Recently, cetuximab has been evaluated with concurrent stereotactic body radiation therapy (SBRT) in a prospective phase II trial for recurrent head and neck carcinomas with one-year progression-free survival of 60% and one-year OS of 40% [22]. Another study is currently evaluating the use of pembrolizumab with concurrent radiation therapy for recurrent head and neck carcinoma (Clinical Trial NCT02318771).…”

Predictors of severe long-term toxicity after re-irradiation for head and neck cancer

“…However, patients amenable to reirradiation via SBRT typically harbor smaller tumor volumes (median 31 cm 3 ) and follow up has typically been much shorter (median 6 months) [19]. Re-irradiation with SBRT by the Pittsburgh group typically involved no expansion from gross tumor to PTV, though 3-5 mm expansions for PTV are now permitted in their current protocols [24,25]. When patients with smaller re-irradiated volumes were examined separately in our cohort, the rate of severe long-term toxicity was comparably low at 13%, although our size threshold for small volumes was <100 cm 3 with a median follow up of 23 months.…”

Advanced Squamous Cell Carcinoma of the Head and Neck: The Current Role of Cetuximab

“…Some studies suggest the use of conventional irradiation and adjuvant CT, but with severe toxicity. Vargo et al [48] examined stereotactic RT and CTX after rescue surgery to improve tumor control and diminish toxicity. Twenty-eight patients with high risk of relapse (positive surgical borders or capsular rupture) were treated with stereotactic RT (40-44 Gy in 5 fractions between 1 and 2 weeks) with concomitant CTX at usual doses.…”