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Stereotactic Body Radiation Therapy for Recurrent Head and Neck Cancer

Ling, Diane C. MD*; Vargo, John A. MD*; Heron, Dwight E. MD, MBA, FACRO, FACR*†

doi: 10.1097/PPO.0000000000000208

Stereotactic body radiation therapy (SBRT) offers a promising opportunity for cure and/or palliation to patients with recurrent head and neck cancer whose comorbidities, performance status, and history of prior treatment may preclude many other salvage options. Stereotactic body radiation therapy appears to have a favorable response and toxicity profile compared with other nonoperative salvage options for recurrent head and neck cancer. However, the risk of severe toxicity remains, with carotid blowout syndrome a unique concern, although the incidence of this complication may be minimized with alternating-day fractionation. The short overall treatment time and low rates of acute toxicity make SBRT an optimal vehicle to integrate with novel systemic therapies, and several phase II studies have used concurrent cetuximab as a radiosensitizer with SBRT with promising results. Ongoing studies aim to evaluate the potential synergistic effect of SBRT with immune checkpoint inhibitors in recurrent head and neck cancer.

From the Departments of *Radiation Oncology and †Otolaryngology, Head & Neck Surgery, University of Pittsburgh Cancer Institute, Pittsburgh PA.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Reprints: Dwight E. Heron, MD, MBA, FACRO, FACR, UPMC Cancer Pavilion, 5150 Centre Ave, Pittsburgh, PA 15232. E-mail:

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