Stereotactic body radiotherapy as primary treatment for elderly patients with medically inoperable head and neck cancer.
Identifieur interne : 002161 ( PubMed/Curation ); précédent : 002160; suivant : 002162Stereotactic body radiotherapy as primary treatment for elderly patients with medically inoperable head and neck cancer.
Auteurs : John A. Vargo [États-Unis] ; Robert L. Ferris [États-Unis] ; David A. Clump [États-Unis] ; Dwight E. Heron [États-Unis]Source :
- Frontiers in oncology [ 2234-943X ] ; 2014.
Abstract
With a growing elderly population, elderly patients with head and neck cancers represent an increasing challenge with limited prospective data to guide management. The complex interplay between advanced age, associated co-morbidities, and conventional local therapies, such as surgery and external beam radiotherapy ± chemotherapy, can significantly impact elderly patients' quality of life (QoL). Stereotactic body radiotherapy (SBRT) is a well-established curative strategy for medical-inoperable early-stage lung cancers even in elderly populations; however, there is limited data examining SBRT as primary therapy in head and neck cancer.
DOI: 10.3389/fonc.2014.00214
PubMed: 25157336
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Ferris</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author><author><name sortKey="Clump, David A" sort="Clump, David A" uniqKey="Clump D" first="David A" last="Clump">David A. Clump</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author><author><name sortKey="Heron, Dwight E" sort="Heron, Dwight E" uniqKey="Heron D" first="Dwight E" last="Heron">Dwight E. Heron</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:25157336</idno><idno type="pmid">25157336</idno><idno type="doi">10.3389/fonc.2014.00214</idno><idno type="wicri:Area/PubMed/Corpus">002170</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002170</idno><idno type="wicri:Area/PubMed/Curation">002161</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002161</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Stereotactic body radiotherapy as primary treatment for elderly patients with medically inoperable head and neck cancer.</title><author><name sortKey="Vargo, John A" sort="Vargo, John A" uniqKey="Vargo J" first="John A" last="Vargo">John A. Vargo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author><author><name sortKey="Ferris, Robert L" sort="Ferris, Robert L" uniqKey="Ferris R" first="Robert L" last="Ferris">Robert L. Ferris</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author><author><name sortKey="Clump, David A" sort="Clump, David A" uniqKey="Clump D" first="David A" last="Clump">David A. Clump</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author><author><name sortKey="Heron, Dwight E" sort="Heron, Dwight E" uniqKey="Heron D" first="Dwight E" last="Heron">Dwight E. Heron</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA </wicri:regionArea></affiliation></author></analytic><series><title level="j">Frontiers in oncology</title><idno type="ISSN">2234-943X</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">With a growing elderly population, elderly patients with head and neck cancers represent an increasing challenge with limited prospective data to guide management. The complex interplay between advanced age, associated co-morbidities, and conventional local therapies, such as surgery and external beam radiotherapy ± chemotherapy, can significantly impact elderly patients' quality of life (QoL). Stereotactic body radiotherapy (SBRT) is a well-established curative strategy for medical-inoperable early-stage lung cancers even in elderly populations; however, there is limited data examining SBRT as primary therapy in head and neck cancer.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">25157336</PMID><DateCreated><Year>2014</Year><Month>08</Month><Day>26</Day></DateCreated><DateCompleted><Year>2014</Year><Month>08</Month><Day>26</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2234-943X</ISSN><JournalIssue CitedMedium="Print"><Volume>4</Volume><PubDate><Year>2014</Year></PubDate></JournalIssue><Title>Frontiers in oncology</Title><ISOAbbreviation>Front Oncol</ISOAbbreviation></Journal><ArticleTitle>Stereotactic body radiotherapy as primary treatment for elderly patients with medically inoperable head and neck cancer.</ArticleTitle><Pagination><MedlinePgn>214</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fonc.2014.00214</ELocationID><Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">With a growing elderly population, elderly patients with head and neck cancers represent an increasing challenge with limited prospective data to guide management. The complex interplay between advanced age, associated co-morbidities, and conventional local therapies, such as surgery and external beam radiotherapy ± chemotherapy, can significantly impact elderly patients' quality of life (QoL). Stereotactic body radiotherapy (SBRT) is a well-established curative strategy for medical-inoperable early-stage lung cancers even in elderly populations; however, there is limited data examining SBRT as primary therapy in head and neck cancer.</AbstractText><AbstractText Label="MATERIAL/METHODS" NlmCategory="METHODS">Twelve patients with medically inoperable head and neck cancer treated with SBRT ± cetuximab from 2002 to 2013 were retrospectively reviewed. SBRT consisted of primarily 44 Gy in five fractions delivered on alternating days over 1-2 weeks. Concurrent cetuximab was administered at a dose of 400 mg/m(2) on day -7 followed by 250 mg/m(2) on day 0 and +7 in n = 3 (25%). Patient-reported quality of life (PRQoL) was prospectively recorded using the previously validated University of Washington quality of life revised (UW-QoL-R).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Median clinical follow-up was 6 months (range: 0.5-29 months). The 1-year actuarial local progression-free survival, distant progression-free survival, progression-free survival, and overall survival for definitively treated patients were 69, 100, 69, and 64%, respectively. One patient (8%) experienced acute grade 3 dysphagia and one patient (8%) experienced late grade 3 mucositis; there were no grade 4-5 toxicities. Prospective collection of PRQoL as assessed by UW-QoL-R was preserved across domains.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Stereotactic body radiotherapy shows encouraging survival and relatively low toxicity in elderly patients with unresectable head and neck cancer, which may provide an aggressive potentially curative local therapy while maintaining QoL.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Vargo</LastName><ForeName>John A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferris</LastName><ForeName>Robert L</ForeName><Initials>RL</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clump</LastName><ForeName>David A</ForeName><Initials>DA</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heron</LastName><ForeName>Dwight E</ForeName><Initials>DE</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA ; Department of Otolaryngology, Division of Head and Neck Surgery, University of Pittsburgh Cancer Institute , Pittsburgh, PA , USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>08</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Front Oncol</MedlineTA><NlmUniqueID>101568867</NlmUniqueID><ISSNLinking>2234-943X</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Radiother Oncol. 2005 Nov;77(2):137-42</RefSource><PMID Version="1">16260054</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Head Neck Oncol. 2010 Nov 26;2:34</RefSource><PMID Version="1">21110844</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>JAMA. 2010 Mar 17;303(11):1070-6</RefSource><PMID Version="1">20233825</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Acta Oncol. 2009;48(4):562-70</RefSource><PMID Version="1">19373698</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Radiat Oncol Biol Phys. 2009 Dec 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