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A systematic review and practical considerations of stereotactic body radiotherapy in the treatment of head and neck cancer

Lookup NU author(s): Nick West, Neil Richmond, David Morgan, Professor Vinidh Paleri, Dr Charles Kelly

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Abstract

OBJECTIVES: Stereotactic radiotherapy (SBRT) is gaining popularity although its use in head and neck cancer (HNC) is not well defined. The primary objective was to review the published evidence regarding the use of stereotactic radiotherapy in HNC. METHODS: A literature search was performed by using MEDLINE and EMBASE databases for eligible studies from 2000 to 2019 and 26 relevant studies were identified. RESULTS: Literature demonstrates a heterogeneous use of this technique with regards to patient population, primary or salvage treatment, dose fractionation regimens, outcomes and follow-up protocols. Carotid blow out syndrome is a risk as with other forms of reirradiation but alternative treatment regimens may reduce this risk. CONCLUSION: At present there is a lack of evidence regarding SBRT as a primary treatment option for HNC and definitive answers regarding efficacy and tolerability cannot be provided but there is growing evidence that SBRT reirradiation regimens are safe and effective. In lieu of evidence from large Phase III trials, we define appropriate organ at risk constraints and prescription doses, with accurate plan summation approaches. Prospective randomised trials are warranted to validate improved treatment outcomes and acceptable treatment morbidity. ADVANCES IN KNOWLEDGE: This article provides a comprehensive review of evidence of use of stereotactic radiotherapy in HNC site (either as a primary treatment or as reirradiation). We also provide an evidence-based approach to the implementation and practical consideration of stereotactic radiotherapy in HNC.

Publication metadata

Author(s): Iqbal MS, West N, Richmond N, Kovarik J, Gray I, Willis N, Morgan D, Yazici G, Cengiz M, Paleri V, Kelly C

Publication type: Article

Publication status: Published

Journal: British Journal of Radiology

Year: 2020

Volume: 94

Issue: 1117

Online publication date: 24/09/2020

Acceptance date: 20/08/2020

ISSN (print): 0007-1285

ISSN (electronic): 1748-880X

Publisher: British Institute of Radiology

URL: https://doi.org/10.1259/bjr.20200332

DOI: 10.1259/bjr.20200332

PubMed id: 32960652

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