Clinical outcome of stereotactic body radiotherapy for lung-only oligometastatic head and neck squamous cell carcinoma: Is the deferral of systemic therapy a potential goal?

Pierluigi Bonomo, Daniela Greto, Isacco Desideri, Mauro Loi, Vanessa Di Cataldo, Ester Orlandi, Nicola Alessandro Iacovelli, Carlotta Becherini, Luca Visani, Viola Salvestrini, Matteo Mariotti, Lorenzo Livi

Research output: Contribution to journalArticle

Abstract

Objectives: Oligometastatic head and neck squamous cell carcinoma (HNSCC) is a rare entity with no evidence-based treatment recommendations available to support the use of local ablative therapies. The aim of our study was to report on the clinical benefit of stereotactic body radiotherapy (SBRT) for patients with lung-only oligometastases, defined by the presence of 1 to 5 pulmonary lesions. Material and Methods: SBRT was applied in case of single lesions deemed amenable to local treatment only (“de novo” pattern) or after first line chemotherapy at time of disease oligoprogression (“induced” pattern). To assess the potential deferral of systemic therapy in both time points, we analyzed time to progression (TTP) defined as the time from the last day of SBRT to disease progression or death from any cause. Cox regression analysis was performed to identify predictive factors of better outcome. Results: Twenty-seven patients were retrospectively evaluated. The majority (81.5%) had HPV negative disease and a “de novo” oligometastatic pattern (78.6%). The median maximum lesion diameter and target size were 1.5 cm and 22.7 cc, respectively. At a median follow-up of 22 months (range 6–73), the median TTP was 10 months (95% CI: 9.5–21.1), with 1- and 2-year rates of 56.2% and 35%, respectively. The objective response rate at 3 months after SBRT was 75%. At multivariate analysis baseline T3/T4 stage had a HR for worse outcome of 5.38 (p = 0.033). Acute toxicity was minimal (G1/G2 of 14.8%). Conclusion: In properly selected oligometastatic patients, SBRT has potential for sustained deferral of systemic treatment.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalOral Oncology
Volume93
DOIs
Publication statusPublished - Jun 2019

Fingerprint

Radiosurgery
Lung
Therapeutics
Disease Progression
Cause of Death
Multivariate Analysis
Regression Analysis
Carcinoma, squamous cell of head and neck
Drug Therapy

Keywords

  • Head and neck cancer
  • Lung metastases
  • Oligometastases
  • Squamous cell carcinoma
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

Clinical outcome of stereotactic body radiotherapy for lung-only oligometastatic head and neck squamous cell carcinoma : Is the deferral of systemic therapy a potential goal? / Bonomo, Pierluigi; Greto, Daniela; Desideri, Isacco; Loi, Mauro; Di Cataldo, Vanessa; Orlandi, Ester; Iacovelli, Nicola Alessandro; Becherini, Carlotta; Visani, Luca; Salvestrini, Viola; Mariotti, Matteo; Livi, Lorenzo.

In: Oral Oncology, Vol. 93, 06.2019, p. 1-7.

Research output: Contribution to journalArticle

Bonomo, Pierluigi ; Greto, Daniela ; Desideri, Isacco ; Loi, Mauro ; Di Cataldo, Vanessa ; Orlandi, Ester ; Iacovelli, Nicola Alessandro ; Becherini, Carlotta ; Visani, Luca ; Salvestrini, Viola ; Mariotti, Matteo ; Livi, Lorenzo. / Clinical outcome of stereotactic body radiotherapy for lung-only oligometastatic head and neck squamous cell carcinoma : Is the deferral of systemic therapy a potential goal?. In: Oral Oncology. 2019 ; Vol. 93. pp. 1-7.
@article{7befe427820641318392f14561db31be,
title = "Clinical outcome of stereotactic body radiotherapy for lung-only oligometastatic head and neck squamous cell carcinoma: Is the deferral of systemic therapy a potential goal?",
abstract = "Objectives: Oligometastatic head and neck squamous cell carcinoma (HNSCC) is a rare entity with no evidence-based treatment recommendations available to support the use of local ablative therapies. The aim of our study was to report on the clinical benefit of stereotactic body radiotherapy (SBRT) for patients with lung-only oligometastases, defined by the presence of 1 to 5 pulmonary lesions. Material and Methods: SBRT was applied in case of single lesions deemed amenable to local treatment only (“de novo” pattern) or after first line chemotherapy at time of disease oligoprogression (“induced” pattern). To assess the potential deferral of systemic therapy in both time points, we analyzed time to progression (TTP) defined as the time from the last day of SBRT to disease progression or death from any cause. Cox regression analysis was performed to identify predictive factors of better outcome. Results: Twenty-seven patients were retrospectively evaluated. The majority (81.5{\%}) had HPV negative disease and a “de novo” oligometastatic pattern (78.6{\%}). The median maximum lesion diameter and target size were 1.5 cm and 22.7 cc, respectively. At a median follow-up of 22 months (range 6–73), the median TTP was 10 months (95{\%} CI: 9.5–21.1), with 1- and 2-year rates of 56.2{\%} and 35{\%}, respectively. The objective response rate at 3 months after SBRT was 75{\%}. At multivariate analysis baseline T3/T4 stage had a HR for worse outcome of 5.38 (p = 0.033). Acute toxicity was minimal (G1/G2 of 14.8{\%}). Conclusion: In properly selected oligometastatic patients, SBRT has potential for sustained deferral of systemic treatment.",
keywords = "Head and neck cancer, Lung metastases, Oligometastases, Squamous cell carcinoma, Stereotactic body radiotherapy",
author = "Pierluigi Bonomo and Daniela Greto and Isacco Desideri and Mauro Loi and {Di Cataldo}, Vanessa and Ester Orlandi and Iacovelli, {Nicola Alessandro} and Carlotta Becherini and Luca Visani and Viola Salvestrini and Matteo Mariotti and Lorenzo Livi",
year = "2019",
month = "6",
doi = "10.1016/j.oraloncology.2019.04.006",
language = "English",
volume = "93",
pages = "1--7",
journal = "Oral Oncology",
issn = "1368-8375",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Clinical outcome of stereotactic body radiotherapy for lung-only oligometastatic head and neck squamous cell carcinoma

T2 - Is the deferral of systemic therapy a potential goal?

AU - Bonomo, Pierluigi

AU - Greto, Daniela

AU - Desideri, Isacco

AU - Loi, Mauro

AU - Di Cataldo, Vanessa

AU - Orlandi, Ester

AU - Iacovelli, Nicola Alessandro

AU - Becherini, Carlotta

AU - Visani, Luca

AU - Salvestrini, Viola

AU - Mariotti, Matteo

AU - Livi, Lorenzo

PY - 2019/6

Y1 - 2019/6

N2 - Objectives: Oligometastatic head and neck squamous cell carcinoma (HNSCC) is a rare entity with no evidence-based treatment recommendations available to support the use of local ablative therapies. The aim of our study was to report on the clinical benefit of stereotactic body radiotherapy (SBRT) for patients with lung-only oligometastases, defined by the presence of 1 to 5 pulmonary lesions. Material and Methods: SBRT was applied in case of single lesions deemed amenable to local treatment only (“de novo” pattern) or after first line chemotherapy at time of disease oligoprogression (“induced” pattern). To assess the potential deferral of systemic therapy in both time points, we analyzed time to progression (TTP) defined as the time from the last day of SBRT to disease progression or death from any cause. Cox regression analysis was performed to identify predictive factors of better outcome. Results: Twenty-seven patients were retrospectively evaluated. The majority (81.5%) had HPV negative disease and a “de novo” oligometastatic pattern (78.6%). The median maximum lesion diameter and target size were 1.5 cm and 22.7 cc, respectively. At a median follow-up of 22 months (range 6–73), the median TTP was 10 months (95% CI: 9.5–21.1), with 1- and 2-year rates of 56.2% and 35%, respectively. The objective response rate at 3 months after SBRT was 75%. At multivariate analysis baseline T3/T4 stage had a HR for worse outcome of 5.38 (p = 0.033). Acute toxicity was minimal (G1/G2 of 14.8%). Conclusion: In properly selected oligometastatic patients, SBRT has potential for sustained deferral of systemic treatment.

AB - Objectives: Oligometastatic head and neck squamous cell carcinoma (HNSCC) is a rare entity with no evidence-based treatment recommendations available to support the use of local ablative therapies. The aim of our study was to report on the clinical benefit of stereotactic body radiotherapy (SBRT) for patients with lung-only oligometastases, defined by the presence of 1 to 5 pulmonary lesions. Material and Methods: SBRT was applied in case of single lesions deemed amenable to local treatment only (“de novo” pattern) or after first line chemotherapy at time of disease oligoprogression (“induced” pattern). To assess the potential deferral of systemic therapy in both time points, we analyzed time to progression (TTP) defined as the time from the last day of SBRT to disease progression or death from any cause. Cox regression analysis was performed to identify predictive factors of better outcome. Results: Twenty-seven patients were retrospectively evaluated. The majority (81.5%) had HPV negative disease and a “de novo” oligometastatic pattern (78.6%). The median maximum lesion diameter and target size were 1.5 cm and 22.7 cc, respectively. At a median follow-up of 22 months (range 6–73), the median TTP was 10 months (95% CI: 9.5–21.1), with 1- and 2-year rates of 56.2% and 35%, respectively. The objective response rate at 3 months after SBRT was 75%. At multivariate analysis baseline T3/T4 stage had a HR for worse outcome of 5.38 (p = 0.033). Acute toxicity was minimal (G1/G2 of 14.8%). Conclusion: In properly selected oligometastatic patients, SBRT has potential for sustained deferral of systemic treatment.

KW - Head and neck cancer

KW - Lung metastases

KW - Oligometastases

KW - Squamous cell carcinoma

KW - Stereotactic body radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=85063946993&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063946993&partnerID=8YFLogxK

U2 - 10.1016/j.oraloncology.2019.04.006

DO - 10.1016/j.oraloncology.2019.04.006

M3 - Article

C2 - 31109688

AN - SCOPUS:85063946993

VL - 93

SP - 1

EP - 7

JO - Oral Oncology

JF - Oral Oncology

SN - 1368-8375

ER -