Strom Tobin, Wishka Christian, Caudell Jimmy J
Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.
Cancer Control. 2016 Jan;23(1):6-11. doi: 10.1177/107327481602300103.
Treatment of locoregional, recurrent head and neck cancers following definitive radiotherapy has evolved during the past 30 years. Brachytherapy as well as protracted courses of systemic therapy and chemoradiotherapy result in 12-month survival rates of 40% to 50% but have high rates of severe toxicity. Given the advancements in radiotherapy targeting and delivery, stereotactic body radiotherapy (SBRT) has been investigated as an alternative treatment option with the potential advantages of reduced treatment time and rates of toxicity.
The authors reviewed prospective trials and retrospective reports from the past decade addressing the management of locoregional, recurrent, previously radiated head and neck cancers, focusing on SBRT.
The body of evidence is growing in support of reirradiation using SBRT for the treatment of recurrent head and neck cancers. The 1-year survival rates associated with SBRT are promising and similar to those seen with chemotherapy alone and concurrent, conventionally fractionated radiotherapy and chemotherapy. Treatment-related adverse events of reirradiation using SBRT are also similar to other palliative therapies. Late carotid rupture is a relatively rare but concerning late toxicity associated with reirradiation using SBRT.
SBRT is a promising treatment for locoregional recurrent head and neck cancers. It also offers a logistical advantage over other palliative treatments, as it only requires 1 to 2 weeks of treatment.
在过去30年中，根治性放疗后局部区域复发性头颈癌的治疗方法不断发展。近距离放疗以及长期的全身治疗和放化疗可使12个月生存率达到40%至50%，但严重毒性发生率较高。鉴于放射治疗靶向和递送技术的进步，立体定向体部放疗（SBRT）已作为一种替代治疗选择进行研究，它具有减少治疗时间和毒性发生率的潜在优势。
作者回顾了过去十年中关于局部区域复发性、曾接受过放疗的头颈癌治疗的前瞻性试验和回顾性报告，重点关注SBRT。
支持使用SBRT对复发性头颈癌进行再放疗的证据越来越多。与SBRT相关的1年生存率很有前景，与单纯化疗以及同期常规分割放疗和化疗的生存率相似。使用SBRT进行再放疗的治疗相关不良事件也与其他姑息治疗相似。晚期颈动脉破裂是与使用SBRT进行再放疗相关的一种相对罕见但令人担忧的晚期毒性反应。
SBRT是治疗局部区域复发性头颈癌的一种有前景的治疗方法。与其他姑息治疗相比，它还具有后勤保障方面的优势，因为它仅需1至2周的治疗时间。
