Table 3.
Summary of SBRT boost studies in head and neck cancer.
| Author (Year)/Subsite/Design | Sample Size (n) | Median Follow Up (Months) | EBRT Dose/Fraction | Boost Dose (Gy)/Fraction | GTV (cc) or Boost Volume (Range) | EQD2 (Gy) (α/β = 10) (Total) | BED10 (Gy) (α/β = 10) (Total) | Margins for Stereotactic Boost (PTV) |
LC (%) | OS (%) | Initial Site of Failure (N) |
Toxicity (N) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tate et al. (1999)/retrospective/nasopahrynx [44] | 23 | 21 (2–64) | 64.8 Gy–70 Gy (Median 66 Gy/ 33 frs) | 7–15 Gy /1#frs Median 12 Gy | Not reported | Median 88 | Median 105.6 | Not reported | 100% | Not reported |
Local: 0 Regional: 2 Distant: 7 | As expected for EBRT |
| Le et al. (2003)/retrospective/nasopahrynx [45] | 45 | 31 | 66 Gy/33 frs | 7–15 Gy/1 frs | Not reported | 88 | 105.6 | Not reported | 3 yr LC: 100% | 3 yr OS: 75% | Local: 0 Regional: 3 Distant: 14 | CN weakness: 4 Retinopathy: 1 Asymptomatic TLN: 3 |
| Chen HH et al. (2006) retrospective/nasopahrynx [47] | 64 | 31 (22–54) | 64.8 Gy–68.4 Gy/36–38 frs | 12–15 Gy/4–5 frs | Mean GTV 62.6 (21.1– 145.3) |
76.72–83.51 | 92.06–100.2 | CTV + 2–3 mm |
3 yr LC: 93.1% | 3 yr OS: 84.9% | Local: 4 Regional: 7 Distant: 7 | Late Grade 4: None Note: 3 fatal nasal bleeding could be not related to SBRT boost |
| Hara et al. (2008)/retrospective/nasopahrynx [46] | 82 | 40.7 (6.5–144.2) | 66 Gy/33 frs | 7–15 Gy/1 frs | Median GTV 34.2 (6.4– 102.2) |
88 | 105.6 | Not reported | 5 yr LC: 98% | 5 yr OS: 69% | Local: 1 Regional: 5 Distant: 27 | Retinopathy: 3 Asymptomatic TLN: 8 Symptomatic: 2 |
| Uno T et al. (2010)/retrospective/mixed [48] | 10 | 16 (6–24) | 40 Gy–60 Gy/20–30 frs | 9–16 Gy/1–3 frs | Not reported | 54.22–80.44 | 65.1–96.53 | CTV + 0–5 mm | CR: 60% PR: 40% | Not reported |
Local: 3 Distant: 1 | ≥Grade 3: None |
| Lee DS et al. (2012) retrospective/mixed [50] | 26 | 56 (27.6–80.2) | 39.6 Gy–70.2 Gy (Median 50.4 Gy/28 frs) | 10–25 Gy/2–5 frs Median 21 Gy/5 frs | NPC median GTV 45.3 (21.3– 69.4) Non-NPC Median GTV 19.4 (6.9–66.8) |
Median 74.41 | Median 89.29 | GTV + 1- mm | 1 yr LRRFR: 91.4% 2 yr LRRFR: 86.3% | 2 yr OS: 61.5% 5 yr OS: 46.2% | Local: 2 Regional: 1 Distant: 5 | ≥Grade 3: 9 |
| Al-Mamgani et al. (2012)/retrospective/oropharynx [51] | 51 | 18 (6–65) | 46 Gy/23 frs | 16.5 Gy/3 frs | Not reported | 67.31 | 80.78 | CTV + 3 mm |
2 yr LC: 86% 3 yr LC: 70% | 2 yr OS: 82% 3 yr OS: 54% | Local: 5 Regional: 1 Distant: 1 | ≥Grade 3: 2 1 feeding tube dependence |
| Yamazaki H et al. (2014) retrospective/mixed [49] | 25 | 28 (7–128) | 35 Gy–70 Gy (Median 50 Gy/25 frs) | 12–35 Gy/1–5 frs Median 15 Gy/3 frs | Not reported | Median 68.75 | Median 82.5 | 2 yr LC: 89% 5 yr LC: 71% | 2 yr OS: 83% 5 yr OS: 70% | - | ≥Grade 3: None | |
| Karam et al., (2014)/retrospective/salivary gland [32] | 10 | 29 (12–120) | Median 64.8, range (50–75.6) | Median17.5, range (10– 30)/3–6 frs |
Not reported |
87.82 (61.11–113.1) | 92.5 (75.91–102.3) | Definitive= GTV + 15– 20 mm Post-op CTV + 10– 20 mm |
1-yr LC: 90% 2-yr LC: 80% |
1 yr: 100% |
Local: 1 Distant: 1 |
≥Grade 3: None |
| Kataria et al., (2015)/retrospective/mixed [55] |
9 | 8 (6–19) | 54 (50–60)/(25–30) | 15 (10–25)/2–5 frs | Median GTV 16.3 (7– 47) |
72.7 (62.5–91.2) | 87.3 (75–109.5) | GTV +3–5 mm |
CR: 55% | Not reported |
Distant: 1 | ≥Grade 3: None |
| Diaz- Martinez et al., (2018)/retrospective/Sinonasal/ nasopharynx [56] |
9 | 13.3 (4–32) | 64.3 (54–70)/(27–35) | 13 (12–20)/1 fr | Mean GTV 4.5 (1.17– 8.2) |
89.2 (76–120) | 107.1 (91.2–144) | Not reported | 1-yr LC: 100% | Not reported | Distant: 3 | ≥Grade 3: None |
| Baker S et al. (2018)/retrospective/oropharynx Baker S et al. (2019)b retrospective/oropharynx [52] |
195 | 42.8 (2.1–98.6) | 46 Gy/23 frs | 16.5 Gy/3 frs | Not reported |
67.31 | 80.78 | CTV + 3 mm |
5 yr LC: 90% | 5 yr OS: 66.7% | Local: 18 Regional: 12 Distant: 11 | ≥Grade 3: 47 |
| Vempati et al., (2020)/prospective/oropharynx [54] | 34 | 50 | 60–66/30 frs | 8–10/1–2 frs | Mean GTVp 70 Mean boost volume 54 (13–185) |
72–79.6 | 86.4–95.5 | CTV = GTV + 7 mm PTV = CTV + 3 mm |
Median follow up of 50 months LC: 85.3% | Median follow up of 50 months OS: 85.3% | Local: 1 Regional: 2Distant: 4 |
≥Grade 3: 4 Dysphagia: 1 Pharyngeal hemorrhage: 3 |