AI Article Synopsis
- The study evaluates the effectiveness of stereotactic body radiotherapy (SBRT) in improving survival outcomes for patients with oligometastatic head-and-neck squamous cell carcinoma (HNSCC) and pulmonary metastases across 16 international centers.
- Out of 178 patients treated, the median overall survival was 33 months, while progression-free survival was 9 months, with low rates of local failure and minimal severe toxicity reported.
- Factors influencing survival included age and sex, with older patients and females having worse outcomes, while a longer time between HNSCC diagnosis and SBRT treatment was linked to better survival rates.
Article Abstract
Purpose: The value of stereotactic body radiotherapy (SBRT) in patients with oligometastatic head-and-neck squamous cell carcinoma (HNSCC) remains unclear, as existing evidence is primarily derived from retrospective single-center analyses with small patient cohorts. This study aimed to evaluate the outcomes of pulmonary SBRT in patients with oligometastatic HNSCC and to identify factors associated with survival.
Methods: This trinational multicenter cohort study, including 16 centers from XXX, XXX, and XXX, retrospectively analyzed patients with oligometastatic HNSCC undergoing SBRT for pulmonary metastases between 2010 and 2023. The primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS) and incidence of local failures.
Results: A total of 178 patients with 284 irradiated lung metastases were analyzed. The most common primary HNSCC subsites were oropharyngeal (n=71), laryngeal (n=37), and hypopharyngeal (n=31). Lung metastases were treated with a median biologically effective dose (BED) of 105 Gy (IQR, 84-113) at the planning target volume periphery. After a median follow-up of 40 months (95% CI, 34-46), the median OS and PFS were 33 months (95% CI, 26-40) and 9 months (95% CI, 7-11), respectively. The 1-year cumulative incidence of local failures was 5.5% (95% CI, 3.1-8.8). One patient (0.6%) developed acute grade 3 dysphagia, and among 146 patients assessed for chronic toxicities, 2 (1.4%) experienced grade 3 events, with no grade 4-5 toxicities. On multivariable analysis, older (>65 years) patients (HR, 1.59; 95% CI, 1.02-2.49; P=.040) and females (HR, 1.76; 95% CI, 1.04-2.99; P=.035) exhibited worse OS, whereas longer time between HNSCC diagnosis and first SBRT was associated with longer OS (HR, 0.99; 95% CI, 0.99-1.00; P=.045).
Conclusion: SBRT for pulmonary metastases achieves excellent local control with minimal toxicity in patients with oligometastatic HNSCC. Prospective trials are needed to determine the optimal timing for integrating SBRT with systemic treatment.
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| http://dx.doi.org/10.1016/j.ijrobp.2024.12.015 | DOI Listing |
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- The study evaluates the effectiveness of stereotactic body radiotherapy (SBRT) in improving survival outcomes for patients with oligometastatic head-and-neck squamous cell carcinoma (HNSCC) and pulmonary metastases across 16 international centers.
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