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Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck

Background and Objectives: Patients with recurrent squamous cell carcinoma of the head and neck (rHNC) face an aggressive disease. Surgical resection is the gold standard treatment. Immediate adjuvant post-operative stereotactic ablative radiotherapy (PO-SABR) for rHNC is debatable. Materials and Me...

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Autores principales: Pellizzon, Antonio, Silva, Maria, Fogaroli, Ricardo, Neto, Elson, Chen, Michael, Godim, Guilherme, Castro, Douglas, Ramos, Henderson, Abrahao, Carolina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415665/
https://www.ncbi.nlm.nih.gov/pubmed/36013541
http://dx.doi.org/10.3390/medicina58081074
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author Pellizzon, Antonio
Silva, Maria
Fogaroli, Ricardo
Neto, Elson
Chen, Michael
Godim, Guilherme
Castro, Douglas
Ramos, Henderson
Abrahao, Carolina
author_facet Pellizzon, Antonio
Silva, Maria
Fogaroli, Ricardo
Neto, Elson
Chen, Michael
Godim, Guilherme
Castro, Douglas
Ramos, Henderson
Abrahao, Carolina
author_sort Pellizzon, Antonio
collection PubMed
description Background and Objectives: Patients with recurrent squamous cell carcinoma of the head and neck (rHNC) face an aggressive disease. Surgical resection is the gold standard treatment. Immediate adjuvant post-operative stereotactic ablative radiotherapy (PO-SABR) for rHNC is debatable. Materials and Methods: We retrospectively identified patients who were treated with PO-SABR at the AC Camargo Cancer Center, Brazil. Results: Eleven patients were treated between 2018 and 2021. The median time between salvage surgery and PO-SABR was 31 days (range, 25–42) and the median PO-SABR total dose was 40 Gy (range, 30–48 Gy). The 2-and 4-year actuarial DFS were 62.3% and 41.6%, while the 2-and 4-year OS probabilities were 80.0% and 53.3%, respectively. Eight (72.7%) patients were alive and six (54.5%) were without disease at the last follow-up. Two (18.1%) patients had local failure in the PO-SABR field. Three (27.3%) patients had distant metastasis, diagnosed in a median time of 9 months (range, 4–13) after completion of PO-SABR. On univariate analysis, predictive factors related to worse OS were: interval between previous radiotherapy and PO-SABR ≤ 24 months (p = 0.033) and location of the salvage target in the oral cavity (p = 0.013). The total dose of PO-SABR given in more than three fractions was marginally statistically significant, favoring the OS (p = 0.051). Conclusions: Our results encourage the use of a more aggressive approach in selected patients with rHNC by combining salvage surgery with immediate PO-SABRT, but this association needs to be further explored.
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spelling pubmed-94156652022-08-27 Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck Pellizzon, Antonio Silva, Maria Fogaroli, Ricardo Neto, Elson Chen, Michael Godim, Guilherme Castro, Douglas Ramos, Henderson Abrahao, Carolina Medicina (Kaunas) Article Background and Objectives: Patients with recurrent squamous cell carcinoma of the head and neck (rHNC) face an aggressive disease. Surgical resection is the gold standard treatment. Immediate adjuvant post-operative stereotactic ablative radiotherapy (PO-SABR) for rHNC is debatable. Materials and Methods: We retrospectively identified patients who were treated with PO-SABR at the AC Camargo Cancer Center, Brazil. Results: Eleven patients were treated between 2018 and 2021. The median time between salvage surgery and PO-SABR was 31 days (range, 25–42) and the median PO-SABR total dose was 40 Gy (range, 30–48 Gy). The 2-and 4-year actuarial DFS were 62.3% and 41.6%, while the 2-and 4-year OS probabilities were 80.0% and 53.3%, respectively. Eight (72.7%) patients were alive and six (54.5%) were without disease at the last follow-up. Two (18.1%) patients had local failure in the PO-SABR field. Three (27.3%) patients had distant metastasis, diagnosed in a median time of 9 months (range, 4–13) after completion of PO-SABR. On univariate analysis, predictive factors related to worse OS were: interval between previous radiotherapy and PO-SABR ≤ 24 months (p = 0.033) and location of the salvage target in the oral cavity (p = 0.013). The total dose of PO-SABR given in more than three fractions was marginally statistically significant, favoring the OS (p = 0.051). Conclusions: Our results encourage the use of a more aggressive approach in selected patients with rHNC by combining salvage surgery with immediate PO-SABRT, but this association needs to be further explored. MDPI 2022-08-10 /pmc/articles/PMC9415665/ /pubmed/36013541 http://dx.doi.org/10.3390/medicina58081074 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pellizzon, Antonio
Silva, Maria
Fogaroli, Ricardo
Neto, Elson
Chen, Michael
Godim, Guilherme
Castro, Douglas
Ramos, Henderson
Abrahao, Carolina
Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck
title Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck
title_full Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck
title_fullStr Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck
title_full_unstemmed Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck
title_short Salvage Post-Operative Stereotatic Ablative Radiotherapy for Re-Current Squamous Cell Carcinoma of Head and Neck
title_sort salvage post-operative stereotatic ablative radiotherapy for re-current squamous cell carcinoma of head and neck
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415665/
https://www.ncbi.nlm.nih.gov/pubmed/36013541
http://dx.doi.org/10.3390/medicina58081074
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