Prospective evaluation of patient-reported quality-of-life outcomes following SBRT ¡À cetuximab for locally-recurrent, previously-irradiated head and neck cancer

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• 作者：John A. Vargo ; Dwight E. Heron ; Robert L. Ferris ; Jean-Claude M. Rwigema ; Rodney E. Wegner ; Ronny Kalash ; James Ohr ; Greg J. Kubicek ; Steven Burton
• 关键词：Stereotactic body radiation therapy (SBRT) ; Recurrent head and neck cancer ; Re-irradiation ; Cetuximab ; Quality-of-life
• 刊名：Radiotherapy and Oncology
• 出版年：2012
• 出版时间：July, 2012
• 年：2012
• 卷：104
• 期：1
• 页码：91-95
• 全文大小：404 K

文摘

Purpose

Stereotactic body radiotherapy (SBRT) has emerged as a promising salvage strategy for unresectable, previously-irradiated recurrent squamous cell carcinomas of the head and neck (rSCCHN). Here-in, we report the first prospective evaluation of patient-reported quality-of-life (PR-QoL) following re-irradiation with SBRT ¡À cetuximab for rSCCHN.

Materials and methods

From November 2004 to May 2011, 150 patients with unresectable, rSCCHN in a previously-irradiated field receiving >40 Gy were treated with SBRT to 40-50 Gy in 5 fractions ¡À concurrent cetuximab. PR-QoL was prospectively acquired using the University of Washington Quality-of-Life Revised (UW-QoL-R).

Results

Overall PR-QoL, health-related PR-QoL, and select domains commonly affected by re-irradiation progressively increase following an initial 1-month decline with statistically significant improvements noted in swallowing (p = 0.025), speech (p = 0.017), saliva (p = 0.041), activity (p = 0.032) and recreation (p = 0.039).

Conclusions

Especially for patients surviving >1-year, improved tumor control associated with SBRT re-irradiation may ameliorate decreased PR-QoL resulting from rSCCHN. These improvements in PR-QoL transcend all measured domains in a validated PR-QoL assessment tool independent of age, use of cetuximab, tumor volume, and interval since prior irradiation.