Table 3.
SBRT reirradiation for head and neck cancer
| Clinical trial | Voynov et al. 2006 | Heron et al. 2009 | Unger et al. 2010 | Roh et al. 2009 | Ozyigit et al. 2009 | Vargo et al. 2012 |
|---|---|---|---|---|---|---|
|
n |
22 |
25 |
65 |
36 |
24 |
34 |
|
Initial therapy dose |
median BED10 97.8 Gy (70.1 – 190.3 Gy) |
median, 64.7 Gy |
median 67 Gy (32–120 Gy) |
median, 70.2 Gy (39.6 – 134.4 Gy) |
median, 70 Gy (48–70 Gy) |
median 61.2 Gy (42–157 Gy). |
|
Interval |
n/s |
13 months (range, 5–94 months) |
26 months (range, 2–318 months) |
24 months (range, 3.1–252.6) |
38 months (range, 10–242 months) |
53 months (range, 1–302 months) |
|
Re-irradiation dose |
5 (1 – 8) x 5 Gy (3 – 16 Gy) |
5 x 5 Gy |
5 (2–5) x 6 |
3 x 10/13 Gy |
5 x 6 Gy |
median dose of 40 Gy in 5 fractions (interquartile range, 30–44 Gy) |
| |
|
5 x 6.4 Gy |
Gy (4–12Gy) |
5 x 5/8 Gy |
|
|
| |
|
5 x 7.2 Gy |
|
|
|
|
| |
|
5 x 8.0 Gy |
median 30 Gy (21–35 Gy) |
|
|
|
| |
|
5 x 8.8 Gy |
|
|
|
|
|
Target size (median) |
TV 19.1 cm3 (range, 2.5 – 140.3 cm3) |
TV 44.8 mm3 (range, 4.2–216.6 mm3) |
Target volume 75 cm3 (range, 7–276 cm3) |
GTV 22.6 cm3 (range, 0.2 to 114.9 cm3) |
TV 63.4 cm3 (range 26.3–170.4 cm3) |
TV 19,6ml (range, 4.5 – 103.9 ml) |
|
Median follow-up time |
19 months (range 11–40 months) |
n/s |
16 months |
17.3 months |
24 months |
10 months (range, 0–55 months) |
|
Local control |
26% @ 2 years |
n/s |
30% @ 2 years * |
61% @ 1 year |
82% @ 2 years |
77% @ 6 months |
| |
|
|
|
52.2% @ 2 years |
|
59% @ 1 year |
|
Overall survival |
22% @ 2 years |
median 6 months (95% CI 5–8 months) |
12 months |
52.1% @ 1 year |
cancer specific survival |
76% @ 6 months |
| |
|
|
41% @ 2 years * |
30.9% @ 2 years |
|
|
| |
|
|
|
|
64% @ 2 years |
59% @ 1 year |
|
Toxicity |
1/22 grade 2, |
3/25 grade 1 |
19/65 acute grade 1–3 toxicities |
13/36 grade 3 acute toxicities |
5/24 severe late side effects (grade ≥ 3) |
Acute/late grade 3 toxicity was 15/6%, with no grade 4–5 toxicity |
| |
1/22 grade 3 mucositis |
1/25 grade 2 |
|
|
|
|
| |
|
No grade 3–5 toxicities |
|
3/36 late toxicity: 1 bone necrosis, 2 soft tissue necrosis |
|
|
| |
No grade 4/5 toxicitiy |
|
|
|
|
|
| |
|
|
6/65 late grade 4 toxicities: arterial bleeding, soft |
|
|
|
| |
|
|
tissue necrosis, fistula formation |
|
|
|
| 1 treatment related death |
Abbreviations: BED10 = biologically effective dose (α/β of 10 for acute/tumor effects); n/s = not specified; @ = at time of; TV = tumor volume; GTV = gross tumor volume.
* definitively treated patients.