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Open Access 08-12-2023 | Radiotherapy | Original Article

Stereotactic radiotherapy in the management of oligometastatic and recurrent head and neck cancer: a single-center experience

Authors: Ahmed Allam Mohamed, Miguel Goncalves, Biney Pal Singh, Mareike Tometten, Ashkan Rashad, Frank Hölzle, Stephan Hackenberg, Michael Eble

Published in: Strahlentherapie und Onkologie | Issue 5/2024

Abstract

Introduction

Oligometastatic disease (OMD) is a metastatic stage that could benefit maximally from local therapies. Patients in this state have a better prognosis relative to those with disseminated metastases. Stereotactic radiotherapy provides a non-invasive ablative tool for primary malignant tumors and metastases.

Materials and methods

We searched our register for patients with oligometastatic or recurrent head and neck cancer (OMD/R-HNC) who received stereotactic radiotherapy to manage their OMD/R. We evaluated the survival outcomes and prognostic factors that affected the survival of those patients.

Results

In all, 31 patients with 48 lesions met the inclusion criteria for the analysis. The lesions comprised various metastatic sites, with the majority being pulmonary (37 lesions). Squamous cell cancer was the most common histology (26 patients). The median overall survival (mOS) was 33 months, with a progression-free survival (PFS) of 9.6 months. Eight patients received subsequent stereotactic radiotherapy after disease progression. The local control (LC) rates were 91.3, 87.7, and 83% at 6, 12, and 36 months. Patients with the de novo OMD who received stereotactic radiotherapy as their initial treatment had a median systemic treatment-free survival of 23.9 months. In univariate analysis, a trend for better OS was observed in patients with p16-positive squamous cell tumors; patients who progressed within 150 days after diagnosis had a significantly lower OS. De novo OMD showed significantly better PFS compared to induced OMD. Multivariate analyses identified p16-positive squamous cell cancer, metachronous OMD and a longer time to progression as positive predictors of OS, while de novo OMD was the only positive predictor for PFS. Treatment-related toxicities were generally mild, with two cases of grade 3 dysphagia reported.

Conclusion

Stereotactic radiotherapy demonstrated favorable outcomes in patients with OMD/R-HNC with limited toxicities. Further studies are warranted to validate these findings and optimize treatment strategies for this patient population.

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Title: Stereotactic radiotherapy in the management of oligometastatic and recurrent head and neck cancer: a single-center experience
Authors: Ahmed Allam Mohamed
Miguel Goncalves
Biney Pal Singh
Mareike Tometten
Ashkan Rashad
Frank Hölzle
Stephan Hackenberg
Michael Eble
Publication date: 08-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Radiotherapy
Metastasis
Published in: Strahlentherapie und Onkologie / Issue 5/2024
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-023-02180-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stereotactic radiotherapy in the management of oligometastatic and recurrent head and neck cancer: a single-center experience

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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