Singh Raj, Jenkins Jan, Davis Joanne, Song Shiyu, Sharma Sanjeev, Vargo John Austin
Virginia Commonwealth University Health System, Department of Radiation Oncology, Richmond, VA, USA.
The Radiosurgery Society, Sunnyvale, CA, USA.
J Radiosurg SBRT. 2022;8(1):11-19.
There is limited data on clinical outcomes following SBRT for patients with metastatic head and neck squamous cell carcinoma (mHNC).
An international SBRT registry was utilized to identify patients. LC and OS were evaluated with the Kaplan-Meier method and a Cox-proportional hazards model for multivariate analysis (MVA) to assess potential prognostic factors.
We identified 81 patients with 98 lesions treated with SBRT. Areas treated included the lung (53.0%), non-regional lymph nodes (16.0%), and spine (12.3%). OS rates at 1 year and 2 years were 66.4% and 43.1%, respectively. Utilizing KPS, spinal disease, and GTV, 1-year OS estimates were 90.9%, 70.4%, 54.5%, and 25% for patients with 0-3 of these factors, respectively (p = 0.002). One-year and 2-year LC rates were both 93.3%. Roughly 17% of patients reported toxicities (none Grade 3+).
SBRT resulted in promising LC for mHNC patients. Spinal disease, GTV, and KPS should be considered in selecting patients with mHNC that may benefit from SBRT.
关于立体定向体部放疗（SBRT）治疗转移性头颈部鳞状细胞癌（mHNC）患者的临床结果数据有限。
利用一个国际SBRT登记处来识别患者。采用Kaplan-Meier法评估局部控制率（LC）和总生存率（OS），并使用Cox比例风险模型进行多变量分析（MVA）以评估潜在的预后因素。
我们识别出81例接受SBRT治疗的患者，共98个病灶。治疗部位包括肺部（53.0%）、非区域淋巴结（16.0%）和脊柱（12.3%）。1年和2年的OS率分别为66.4%和43.1%。利用KPS、脊柱疾病和肿瘤靶体积（GTV），这些因素0至3项的患者1年OS估计值分别为90.9%、70.4%、54.5%和25%（p = 0.002）。1年和2年的LC率均为93.3%。约17%的患者报告有不良反应（均无3级以上）。
SBRT对mHNC患者的局部控制效果良好。在选择可能从SBRT中获益的mHNC患者时，应考虑脊柱疾病、GTV和KPS。
