Stereotactic Body Radiotherapy as Primary Therapy for Head and Neck Cancer in the Elderly or Patients with Poor Performance

Amini, Arya; McDermott, Jessica D.; Gan, Gregory N.; Sumner, Whitney; Fisher, Christine M.; Jimeno, Antonio; Bowles, Daniel W.; Raben, David; Karam, Sana D.

doi:10.3389/fonc.2014.00274

Cited by 24 publications

(26 citation statements)

References 36 publications

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“…Amini et al . reported on three cases from the University of Colorado using 6 Gy daily for five fractions, 5 Gy daily for five fractions, or 7.2 Gy twice weekly for five fractions 10 . All three patients tolerated their treatments well with minimal toxicity.…”

Section: Discussionmentioning

confidence: 99%

Role of concurrent chemoradiotherapy and stereotactic body radiation treatment for palliation of previously untreated head and neck cancers

Thomas

Packianathan

Ahmed

et al. 2020

Precision Radiation Oncology

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Palliative concurrent chemoradiotherapy has not been well evaluated for patients who are not a candidate for definitive treatment. Even though stereotactic radiotherapy has established a role in the re‐irradiation of recurrent head and neck tumors, its role is not established as a possible primary treatment modality for patients who are not eligible for curative treatment. This article reviews the available literature on the role of chemoradiotherapy and stereotactic radiation for palliation of previously untreated head and neck cancers.

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Section: Discussionmentioning

confidence: 99%

Role of concurrent chemoradiotherapy and stereotactic body radiation treatment for palliation of previously untreated head and neck cancers

Thomas

Packianathan

Ahmed

et al. 2020

Precision Radiation Oncology

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“…These techniques have been associated with lower toxicities than other forms of radiation therapy in various types of cancers including cancer of the prostate, head and neck, breast, bladder, and rectum [ 93 – 97 ]. Stereotactic body radiation therapy (SBRT) allows for higher dosages to be delivered to a targeted tumor region with fewer numbers of fractions [ 98 ] and has been associated with a lower incidence of toxicities [ 99 ], such as radiation pneumonitis in NSCLC treatment for instance [ 100 ]. A recent study on brain metastases found that stereotactic radiosurgery (SRS) alone compared with SRS with whole brain RT can lead to a better conservation of cognitive ability and quality of life without compromising survival [ 101 ].…”

Section: Special Radiation Treatment Considerationsmentioning

confidence: 99%

Managing an Older Adult with Cancer: Considerations for Radiation Oncologists

Chang

Goldstein

Dharmarajan

2017

BioMed Research International

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Older adults with cancer present a unique set of management complexities for oncologists and radiation oncologists. Prognosis and resilience to cancer treatments are notably dependent on the presence or risk of “geriatric syndromes,” in addition to cancer stage and histology. Recognition, proper evaluation, and management of these conditions in conjunction with management of the cancer itself are critical and can be accomplished by utilization of various geriatric assessment tools. Here we review principles of the geriatric assessment, common geriatric syndromes, and application of these concepts to multidisciplinary oncologic treatment. Older patients may experience toxicities related to treatments that impact treatment effectiveness, quality of life, treatment-related mortality, and treatment compliance. Treatment-related burdens from radiotherapy are increasingly important considerations and include procedural demands, travel, costs, and temporary or permanent loss of functional independence. An overall approach to delivering radiotherapy to an older cancer patient requires a comprehensive assessment of both physical and nonphysical factors that may impact treatment outcome. Patient and family-centered communication is also an important part of developing a shared understanding of illness and reasonable expectations of treatment.

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“…15 Although the most common use of SBRT for HNC is in the setting of re-irradiation as evidenced by multiple prospective trials, several studies have retrospectively addressed its use as primary treatment, albeit limited by small patient numbers. [16][17][18][19][20][21][22][23][24][25] We hypothesize that SBRT provides high rates of LC while minimizing toxicity in patients who are unfit for conventional definitive treatment modalities.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy as primary treatment for elderly and medically inoperable patients with head and neck cancer

et al. 2020

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Background Patients with head and neck cancer (HNC) who are not candidates for definitive treatment represent an increasing challenge, with limited data to guide management. Conventional local therapies such as surgery and chemoradiation can significantly impact quality of life (QoL). There has been limited data published using stereotactic body radiotherapy (SBRT) as primary treatment in previously unirradiated patients. We hypothesize that SBRT provides high rates of control while limiting toxicity. Methods A total of 66 medically unfit previously unirradiated patients with HNC were treated with SBRT, consisting of 35‐40 Gy to gross tumor volume and 30 Gy to clinical target volume in five fractions. Results Median age was 80 years. Local control (LC) and overall survival (OS) at 1 year were 73% and 64%. Two patients experienced grade 3 toxicity. Conclusion SBRT shows acceptable outcomes with relatively low toxicity in previously unirradiated patients with HNC who are medically unfit for conventional treatment. SBRT may provide an aggressive local therapy with high rates of LC and OS while maintaining QoL.

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Stereotactic Body Radiotherapy as Primary Therapy for Head and Neck Cancer in the Elderly or Patients with Poor Performance

Cited by 24 publications

References 36 publications

Role of concurrent chemoradiotherapy and stereotactic body radiation treatment for palliation of previously untreated head and neck cancers

Role of concurrent chemoradiotherapy and stereotactic body radiation treatment for palliation of previously untreated head and neck cancers

Managing an Older Adult with Cancer: Considerations for Radiation Oncologists

Stereotactic body radiotherapy as primary treatment for elderly and medically inoperable patients with head and neck cancer

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