Medical Radiology and radiation safety Medical Radiology and radiation safety Медицинская радиология и радиационная безопасность 1024-6177 2618-9615 49046 10.12737/1024-6177-2022-67-1-65-76 Лучевая терапия Radiation therapy Лучевая терапия Stereotactic Body Radiation Therapy (SBRT) in Patients with Head and Neck Cancer Treatment. Current State of the Problem СТЕРЕОТАКСИЧЕСКАЯ ЛУЧЕВАЯ ТЕРАПИЯ БОЛЬНЫХ ОПУХОЛЯМИ ГОЛОВЫ И ШЕИ. СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ Геворков А. Р. Gevorkov A. R. Бойко А. В. Boyko A. V. Каприн А. Д. Kaprin A. D. Национальный медицинский исследовательский центр радиологии Минздрава России, МНИОИ им. П.А.Герцена - филиал НМИЦ радиологии Минздрава России, Москва Россия P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Moscow, Russia Russian Federation Национальный медицинский исследовательский центр радиологии Минздрава России, МНИОИ им. П.А.Герцена - филиал НМИЦ радиологии Минздрава России, Москва Россия P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Moscow, Russia Russian Federation Национальный медицинский исследовательский центр радиологии Минздрава России, МНИОИ им. П.А.Герцена - филиал НМИЦ радиологии Минздрава России, Москва Россия P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Moscow, Russia Russian Federation 03 03 2022 03 03 2022 67 1 65 76 01 03 2022 https://zh-szf.ru/en/nauka/article/49046/view

Данная публикация представляет собой обзор сегодняшнего состояния проблемы применения стереотаксической лучевой терапии (SBRT) при лечении больных опухолями головы и шеи (ОГШ). Нами проанализированы современные тендеции в ведении пациентов, а также представлены особенности радиобиологии и основные принципы лучевого лечения новообразований вышеуказанной локализации. Отдельное внимание уделено показаниям к проведению стереотаксической лучевой терапии, схемам фракционирования и планирования облучения. Подробно изложен накопленный опыт лучевого лечения с применением SBRT больных первичными ОГШ, в том числе в качестве метода дополнительного прицельного облучения (буста), а также в рамках повторной лучевой терапии при рецидивах. Представлены результаты реализации SBRT различными авторами как в качестве самостоятельной опции, так и в сочетании с лекарственной терапией. В сводной форме с уточняющими комментариями описана эффективность и переносимость облучения. Подробно приведен профиль токсичности лучевой терапии с указанием ключевых факторов риска развития осложнений.

This publication provides an overview of the current state of the art in the use of stereotactic radiation therapy (SBRT) for patients with head and neck tumors. We have analyzed current trends, and also presented the features of radiobiology and the basic principles of radiation treatment. Special attention is paid to indications for SBRT, fractionation schemes and radiation planning. The use of SBRT for primary head and neck tumors, including boost, as well as relapses treatment are described. The results of the implementation of SBRT by various authors both as an independent option and in combination with drug therapy are presented. The efficacy and tolerance of radiation is described in a summary form with clarifying comments. The radiation therapy toxicity profile is detailed, including the main risk factors of postradiation complications.

 опухоли головы и шеи стереотаксическая лучевая терапия SBRT head – neck cancer stereotactic body radion therapy SBRT

Bray F. International Agency for Research on Cancer, American Cancer Society, et all. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide. CA CANCER J. CLIN. 2018;68:394-424. Bray F. International Agency for Research on Cancer, American Cancer Society, et all. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide. CA CANCER J. CLIN. 2018;68:394-424. Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2019;5;12:1749-1768. doi:10.1001/jamaoncol.2019.2996. Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2019;5;12:1749-1768. doi:10.1001/jamaoncol.2019.2996. Kaprin A.D., Starinskiy V.V., Petrova G.V. Sostoyaniye Onkologicheskoy Pomoshchi Naseleniyu Rossii v 2018 Godu = The State of Cancer Care for the Population of Russia in 2018. Moscow, MNIOI im. N. I. Gertsena Publ., 2019. 236 p. (In Russ.). [Каприн А.Д., Старинский В.В., Г. В. Петрова. Состояние онкологической помощи населению России в 2018 году. М.: МНИОИ им. Н. И. Герцена, 2019. 236 с.]. Kaprin A.D., Starinskiy V.V., Petrova G.V. Sostoyaniye Onkologicheskoy Pomoshchi Naseleniyu Rossii v 2018 Godu = The State of Cancer Care for the Population of Russia in 2018. Moscow, MNIOI im. N. I. Gertsena Publ., 2019. 236 p. (In Russ.). [Kaprin A.D., Starinskiy V.V., G. V. Petrova. Sostoyanie onkologicheskoy pomoschi naseleniyu Rossii v 2018 godu. M.: MNIOI im. N. I. Gercena, 2019. 236 s.]. Shah J.P., Patel S.G., Singh B., Wong R. Jatin Shah’s Head and Neck Surgery and Oncology, Fifth Edition. Elsevier, 2020. 859 p. Shah J.P., Patel S.G., Singh B., Wong R. Jatin Shah’s Head and Neck Surgery and Oncology, Fifth Edition. Elsevier, 2020. 859 p. Lee W.T., Esclamado R.M. Salvage Surgery after Chemoradiation Therapy. In: Adelstein DJ, Editor. Squamous Cell Head and Neck Cancer: Recent Clinical Progress and Prospects for the Future. Totowa, NJ, Humana Press, 2005. P. 69-78. Lee W.T., Esclamado R.M. Salvage Surgery after Chemoradiation Therapy. In: Adelstein DJ, Editor. Squamous Cell Head and Neck Cancer: Recent Clinical Progress and Prospects for the Future. Totowa, NJ, Humana Press, 2005. P. 69-78. Ed. Maghami E., Allen S. Multidisciplinary Care of the Head and Neck Cancer Patient. Springer, 2018. DOI: 10.1007/978-3-319-65421-8. Ed. Maghami E., Allen S. Multidisciplinary Care of the Head and Neck Cancer Patient. Springer, 2018. DOI: 10.1007/978-3-319-65421-8. Ed. Hoskin P. Radiotherapy in Practice: External Beam Therapy. Oxford University Press, 2019. 545 p. Ed. Hoskin P. Radiotherapy in Practice: External Beam Therapy. Oxford University Press, 2019. 545 p. Hansen E.K., Roach M. Handbook of Evidence-Based Radiation Oncology. Springer International Publishing AG, 2018. 937 p. DOI: 10.1007/978-3-319-62642-0. Hansen E.K., Roach M. Handbook of Evidence-Based Radiation Oncology. Springer International Publishing AG, 2018. 937 p. DOI: 10.1007/978-3-319-62642-0. Pignon J.P., Maitre A.L., Maillard E., Bourhis J. On Behalf of the MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy in Head and Neck Cancer (MACH-NC): an Update on 93 Randomised Trials and 17,346 Patients. Radiother. Oncol. 2009;92;1:4-14. DOI: 10.1016/j.radonc.2009.04.014. Pignon J.P., Maitre A.L., Maillard E., Bourhis J. On Behalf of the MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy in Head and Neck Cancer (MACH-NC): an Update on 93 Randomised Trials and 17,346 Patients. Radiother. Oncol. 2009;92;1:4-14. DOI: 10.1016/j.radonc.2009.04.014. Huncharek M., et al. Combined Chemoradiation Versus Radiation Therapy Alone in Locally Advanced Nasopharyngeal Carcinoma: Results of a Meta-Analysis of 1,528 Patients from Six Randomized Trials. Am. J. Clin. Oncol. 2002;25;3:219-223. Huncharek M., et al. Combined Chemoradiation Versus Radiation Therapy Alone in Locally Advanced Nasopharyngeal Carcinoma: Results of a Meta-Analysis of 1,528 Patients from Six Randomized Trials. Am. J. Clin. Oncol. 2002;25;3:219-223. Rades D., Seidl D., Janssen S., et al. Comparison of Weekly Administration of Cisplatin Versus three Courses of Cisplatin 100 mg/m2 for Definitive Radiochemotherapy of Locally Advanced Head-and-Neck Cancers. BMC Cancer. 2016;16:437. Rades D., Seidl D., Janssen S., et al. Comparison of Weekly Administration of Cisplatin Versus three Courses of Cisplatin 100 mg/m2 for Definitive Radiochemotherapy of Locally Advanced Head-and-Neck Cancers. BMC Cancer. 2016;16:437. Bonner J.A., Harari P.M., Giralt J. Radiotherapy Plus Cetuximab for Squamous-Cell Carcinoma of the Head and Neck. N. Engl. J. Med. 2006;354:567. Bonner J.A., Harari P.M., Giralt J. Radiotherapy Plus Cetuximab for Squamous-Cell Carcinoma of the Head and Neck. N. Engl. J. Med. 2006;354:567. Overgaard J., Mohanti B.K., Begum N., et al. Five Versus Six Fractions of Radiotherapy Per Week for Squamous-Cell Carcinoma of the Head and Neck (IAEA-ACC study): a Randomised, Multicentre Trial. Lancet Oncol 2010;11:553-560. Overgaard J., Mohanti B.K., Begum N., et al. Five Versus Six Fractions of Radiotherapy Per Week for Squamous-Cell Carcinoma of the Head and Neck (IAEA-ACC study): a Randomised, Multicentre Trial. Lancet Oncol 2010;11:553-560. Ed. Edward C. Halperin, Carlos A. Perez, Luther W. Brady. Perez and Brady's Principles and Practice of Radiation Oncology. Lippincott Williams & Wilkins, 2013. Ed. Edward C. Halperin, Carlos A. Perez, Luther W. Brady. Perez and Brady's Principles and Practice of Radiation Oncology. Lippincott Williams & Wilkins, 2013. Karam I., Yao M., Heron D.E., Poon I., Koyfman S.A., Yom S..S, et al. Survey of Current Practices from the International Stereotactic Body Radiotherapy Consortium (ISBRTC) for Head and Neck Cancers. Future Oncol. 2017;13;7:603-613. Karam I., Yao M., Heron D.E., Poon I., Koyfman S.A., Yom S..S, et al. Survey of Current Practices from the International Stereotactic Body Radiotherapy Consortium (ISBRTC) for Head and Neck Cancers. Future Oncol. 2017;13;7:603-613. Baliga S., Kabarriti R., Ohri N., Haynes-Lewis H., Yaparpalvi R., Kalnicki S., et al. Stereotactic Body Radiotherapy for Recurrent Head and Neck Cancer: a Critical Review. Head Neck. 2017;39;3:595-601. Baliga S., Kabarriti R., Ohri N., Haynes-Lewis H., Yaparpalvi R., Kalnicki S., et al. Stereotactic Body Radiotherapy for Recurrent Head and Neck Cancer: a Critical Review. Head Neck. 2017;39;3:595-601. Karam I., Poon I., Lee J., Liu S., Higgins K., Enepekides D., et al. Stereotactic Body Radiotherapy for Head and Neck Cancer: an Addition to the Armamentarium Against Head and Neck Cancer. Future Oncol. 2015;11;21:2937-2947. Karam I., Poon I., Lee J., Liu S., Higgins K., Enepekides D., et al. Stereotactic Body Radiotherapy for Head and Neck Cancer: an Addition to the Armamentarium Against Head and Neck Cancer. Future Oncol. 2015;11;21:2937-2947. Guerrero M., Li X.A. Extending the Linear-Quadratic Model for Large Fraction Doses Pertinent to Stereotactic Radiotherapy. Phys. Med. Biol. 2004;49;20:4825-4835. Guerrero M., Li X.A. Extending the Linear-Quadratic Model for Large Fraction Doses Pertinent to Stereotactic Radiotherapy. Phys. Med. Biol. 2004;49;20:4825-4835. Hanin L.G., Zaider M. Cell-Survival Probability at Large Doses: an Alternative to the Linear-Quadratic Model. Phys. Med. Biol. 2010;55;16:4687-4702. Hanin L.G., Zaider M. Cell-Survival Probability at Large Doses: an Alternative to the Linear-Quadratic Model. Phys. Med. Biol. 2010;55;16:4687-4702. Brown J.M., Carlson D.J., Brenner D.J. The Tumor Radiobiology of SRS and SBRT: are more than the 5 Rs Involved? Int. J. Radiat. Oncol. Biol. Phys. 2014;88;2:254-262. Brown J.M., Carlson D.J., Brenner D.J. The Tumor Radiobiology of SRS and SBRT: are more than the 5 Rs Involved? Int. J. Radiat. Oncol. Biol. Phys. 2014;88;2:254-262. Brown J.M., Carlson D.J., Brenner D.J. Dose Escalation, not “New Biology,” Can Account for the Efficacy of Stereotactic Body Radiation Therapy with Non-Small Cell Lung Cancer. In Reply to Rao, et al. Int. J. Radiat. Oncol. Biol. Phys. 2014;89;3:693-694. doi: 10.1016/j.ijrobp.2014.03.014. Brown J.M., Carlson D.J., Brenner D.J. Dose Escalation, not “New Biology,” Can Account for the Efficacy of Stereotactic Body Radiation Therapy with Non-Small Cell Lung Cancer. In Reply to Rao, et al. Int. J. Radiat. Oncol. Biol. Phys. 2014;89;3:693-694. doi: 10.1016/j.ijrobp.2014.03.014. Kirkpatrick J.P., Brenner D.J., Orton C.G. Point/Counterpoint. The Linear-Quadratic Model is Inappropriate to Model High Dose Per Fraction Effects in Radiosurgery. Med. Phys. 2009;36;8:3381-3384. Kirkpatrick J.P., Brenner D.J., Orton C.G. Point/Counterpoint. The Linear-Quadratic Model is Inappropriate to Model High Dose Per Fraction Effects in Radiosurgery. Med. Phys. 2009;36;8:3381-3384. Wang J.Z., Huang Z., Lo S.S., Yuh W.T., Mayr N.A. A Generalized Linear-Quadratic Model for Radiosurgery, Stereotactic Body Radiation Therapy, and High-Dose Rate Brachytherapy. Sci. Transl. Med. 2010;2:39ra48. doi: 10.1126/scitranslmed.3000864. Wang J.Z., Huang Z., Lo S.S., Yuh W.T., Mayr N.A. A Generalized Linear-Quadratic Model for Radiosurgery, Stereotactic Body Radiation Therapy, and High-Dose Rate Brachytherapy. Sci. Transl. Med. 2010;2:39ra48. doi: 10.1126/scitranslmed.3000864. Hoffmann A.L., Nahum A.E. Fractionation in Normal Tissues: the (α/β)eff Concept Can Account for Dose Heterogeneity and Volume Effects. Physics in Medicine and Biology. 2013;58;19:6897-6914. Hoffmann A.L., Nahum A.E. Fractionation in Normal Tissues: the (α/β)eff Concept Can Account for Dose Heterogeneity and Volume Effects. Physics in Medicine and Biology. 2013;58;19:6897-6914. Song C.W., Terezakis S., et al. Indirect Cell Death and the LQ Model in SBRT and SRS. Jour. of Radiosurgery and SBRT. 2020;7:1-4. Song C.W., Terezakis S., et al. Indirect Cell Death and the LQ Model in SBRT and SRS. Jour. of Radiosurgery and SBRT. 2020;7:1-4. McMahon S.J. The Linear Quadratic Model: Usage, Interpretation and Challenges. Phys. Med. Biol. 2019;64;1:01TR01. doi.org/10.1088/1361-6560/aaf26a. McMahon S.J. The Linear Quadratic Model: Usage, Interpretation and Challenges. Phys. Med. Biol. 2019;64;1:01TR01. doi.org/10.1088/1361-6560/aaf26a. Deloch L., Derer A., Hartmann J., Frey B., Fietkau R., Gaipl U.S. Modern Radiotherapy Concepts and the Impact of Radiation on Immune Activation. Front. Oncol. 2016;6:141. doi: 10.3389/fonc.2016.00141. Deloch L., Derer A., Hartmann J., Frey B., Fietkau R., Gaipl U.S. Modern Radiotherapy Concepts and the Impact of Radiation on Immune Activation. Front. Oncol. 2016;6:141. doi: 10.3389/fonc.2016.00141. Ed. Orit Kaidar-Person, Ronald Chen. Hypofractionated and Stereotactic Radiation Therapy. A Practical Guide. Springer, Cham, 2018. 406 p. doi.org/10.1007/978-3-319-92802-9. Ed. Orit Kaidar-Person, Ronald Chen. Hypofractionated and Stereotactic Radiation Therapy. A Practical Guide. Springer, Cham, 2018. 406 p. doi.org/10.1007/978-3-319-92802-9. Ed. Heron D.E., Huq M., Saiful M.S., Herman J.M. Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy (SBRT). Springer, Cham, 2019. 435 p. Ed. Heron D.E., Huq M., Saiful M.S., Herman J.M. Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy (SBRT). Springer, Cham, 2019. 435 p. Ed. Mark Trombetta, Jean-Philippe Pignol, Paolo Montemaggi, Luther W. Brady. Alternate Fractionation in Radiotherapy Paradigm Change. Springer, Cham, 2018. 413 p. doi.org/10.1007/978-3-319-51198-6. Ed. Mark Trombetta, Jean-Philippe Pignol, Paolo Montemaggi, Luther W. Brady. Alternate Fractionation in Radiotherapy Paradigm Change. Springer, Cham, 2018. 413 p. doi.org/10.1007/978-3-319-51198-6. Ed. Sethi R.A., et al. Handbook of Evidence-Based Stereotactic Radiosurgery and Stereotactic Body Radiotherapy. Springer, Cham, 2016. 245 p. DOI: 10.1007/978-3-319-21897-7. Ed. Sethi R.A., et al. Handbook of Evidence-Based Stereotactic Radiosurgery and Stereotactic Body Radiotherapy. Springer, Cham, 2016. 245 p. DOI: 10.1007/978-3-319-21897-7. Vargo J.A., Ward M.C., Caudell J.J., Riaz N., Dunlap N.E., Isrow D., et al. A Multi-Institutional Comparison of SBRT and IMRT for Definitive Reirradiation of Recurrent or Second Primary Head and Neck Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2018;100;3:595-605. Vargo J.A., Ward M.C., Caudell J.J., Riaz N., Dunlap N.E., Isrow D., et al. A Multi-Institutional Comparison of SBRT and IMRT for Definitive Reirradiation of Recurrent or Second Primary Head and Neck Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2018;100;3:595-605. Yamazaki H., Ogita M., Himei K., Nakamura S., Yoshida K., Kotsuma T., et al. Hypofractionated Stereotactic Radiotherapy Using CyberKnife as a Boost Treatment for Head and Neck Cancer, a Multi-Institutional Survey: Impact of Planning Target Volume. Anticancer Res. 2014;34;10:5755-9. Yamazaki H., Ogita M., Himei K., Nakamura S., Yoshida K., Kotsuma T., et al. Hypofractionated Stereotactic Radiotherapy Using CyberKnife as a Boost Treatment for Head and Neck Cancer, a Multi-Institutional Survey: Impact of Planning Target Volume. Anticancer Res. 2014;34;10:5755-9. Yamazaki H., Ogita M., Himei K., Nakamura S., Kotsuma T., Yoshida K., et al. Carotid Blowout Syndrome in Pharyngeal Cancer Patients Treated by Hypofractionated Stereotactic Re-Irradiation Using CyberKnife: a Multi-Institutional Matched-Cohort Analysis. Radiother Oncol. 2015;115;1:67-71. Yamazaki H., Ogita M., Himei K., Nakamura S., Kotsuma T., Yoshida K., et al. Carotid Blowout Syndrome in Pharyngeal Cancer Patients Treated by Hypofractionated Stereotactic Re-Irradiation Using CyberKnife: a Multi-Institutional Matched-Cohort Analysis. Radiother Oncol. 2015;115;1:67-71. Syrigos K.N., Karachalios D., Karapanagiotou E.M., Nutting C.M., Manolopoulos L., Harrington K.J. Head and Neck Cancer in the Elderly: an Overview on the Treatment Modalities. Cancer Treat Rev. 2009;35;3:237-245. Syrigos K.N., Karachalios D., Karapanagiotou E.M., Nutting C.M., Manolopoulos L., Harrington K.J. Head and Neck Cancer in the Elderly: an Overview on the Treatment Modalities. Cancer Treat Rev. 2009;35;3:237-245. Huang S.H., O’Sullivan B., Waldron J., Lockwood G., Bayley A., Kim J., et al. Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: a Single-Center Cohort Study. Int. J. Radiat. Oncol. Biol. Phys. 2011;79;1:46-51. Huang S.H., O’Sullivan B., Waldron J., Lockwood G., Bayley A., Kim J., et al. Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: a Single-Center Cohort Study. Int. J. Radiat. Oncol. Biol. Phys. 2011;79;1:46-51. Monnier L., Touboul E., Durdux C., Lang P., St Guily J.L., Huguet F. Hypofractionated Palliative Radiotherapy for Advanced Head and Neck Cancer: the IHF2SQ Regimen. Head Neck. 2013;35;12:1683-1688. Monnier L., Touboul E., Durdux C., Lang P., St Guily J.L., Huguet F. Hypofractionated Palliative Radiotherapy for Advanced Head and Neck Cancer: the IHF2SQ Regimen. Head Neck. 2013;35;12:1683-1688. Bonomo P., Desideri I., Loi M., Lo Russo M., Olmetto E., Maragna V., et al. Elderly Patients Affected by Head and Neck Squamous Cell Carcinoma Unfit for Standard Curative Treatment: is De-Intensified, Hypofractionated Radiotherapy a Feasible Strategy? Oral Oncol. 2017;74:142-7. Bonomo P., Desideri I., Loi M., Lo Russo M., Olmetto E., Maragna V., et al. Elderly Patients Affected by Head and Neck Squamous Cell Carcinoma Unfit for Standard Curative Treatment: is De-Intensified, Hypofractionated Radiotherapy a Feasible Strategy? Oral Oncol. 2017;74:142-7. Corry J., Peters L.J., Costa I.D., Milner A.D., Fawns H., Rischin D., et al. The ‘QUAD SHOT’-a Phase II Study of Palliative Radiotherapy for Incurable Head and Neck Cancer. Radiother Oncol. 2005;77;2:137-142. Corry J., Peters L.J., Costa I.D., Milner A.D., Fawns H., Rischin D., et al. The ‘QUAD SHOT’-a Phase II Study of Palliative Radiotherapy for Incurable Head and Neck Cancer. Radiother Oncol. 2005;77;2:137-142. Teckie S., Lok B.H., Rao S., Gutiontov S.I., Yamada Y., Berry S.L., et al. High-Dose Hypofractionated Radiotherapy is Effective and Safe for Tumors in the Head-and-Neck. Oral Oncol. 2016;60:74-80. Teckie S., Lok B.H., Rao S., Gutiontov S.I., Yamada Y., Berry S.L., et al. High-Dose Hypofractionated Radiotherapy is Effective and Safe for Tumors in the Head-and-Neck. Oral Oncol. 2016;60:74-80. Siddiqui F., Patel M., Khan M., McLean S., Dragovic J., Jin J., et al. Stereotactic Body Radiation Therapy for Primary, Recurrent, and Metastatic Tumors in the Head-and-Neck Region. Int. J. Radiat. Oncol Biol. Phys. 2009;74;4:1047-1053. Siddiqui F., Patel M., Khan M., McLean S., Dragovic J., Jin J., et al. Stereotactic Body Radiation Therapy for Primary, Recurrent, and Metastatic Tumors in the Head-and-Neck Region. Int. J. Radiat. Oncol Biol. Phys. 2009;74;4:1047-1053. Kodani N., Yamazaki H., Tsubokura T., Shiomi H., Kobayashi K., Nishimura T., et al. Stereotactic Body Radiation Therapy for Head and Neck Tumor: Disease Control and Morbidity Outcomes. J. Radiat. Res. 2011;52;1:24-31. Kodani N., Yamazaki H., Tsubokura T., Shiomi H., Kobayashi K., Nishimura T., et al. Stereotactic Body Radiation Therapy for Head and Neck Tumor: Disease Control and Morbidity Outcomes. J. Radiat. Res. 2011;52;1:24-31. Kawaguchi K., Sato K., Yamada H., Horie A., Nomura T., Iketani S., et al. Stereotactic Radiosurgery in Combination with Chemotherapy as Primary Treatment for Head and Neck Cancer. J. Oral Maxillofac. Surg. 2012;70;2:461-472. Kawaguchi K., Sato K., Yamada H., Horie A., Nomura T., Iketani S., et al. Stereotactic Radiosurgery in Combination with Chemotherapy as Primary Treatment for Head and Neck Cancer. J. Oral Maxillofac. Surg. 2012;70;2:461-472. Vargo J.A., Ferris R.L., Clump D.A., Heron D.E. Stereotactic Body Radiotherapy as Primary Treatment for Elderly Patients with Medically Inoperable Head and Neck Cancer. Front Oncol. 2014;4:214. Vargo J.A., Ferris R.L., Clump D.A., Heron D.E. Stereotactic Body Radiotherapy as Primary Treatment for Elderly Patients with Medically Inoperable Head and Neck Cancer. Front Oncol. 2014;4:214. Khan L., Tjong M., Raziee H., Lee J., Erler D., Chin L., et al. Role of Stereotactic Body Radiotherapy for Symptom Control in Head and Neck Cancer Patients. Support Care Cancer. 2015;23;4:1099. Khan L., Tjong M., Raziee H., Lee J., Erler D., Chin L., et al. Role of Stereotactic Body Radiotherapy for Symptom Control in Head and Neck Cancer Patients. Support Care Cancer. 2015;23;4:1099. Kang B.-H., Yu T., Kim J.H., Park J.M., Kim J.-I., Chung E.-J., et al. Early Closure of a Phase 1 Clinical Trial for SABR in Early-Stage Glottic Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2019;105:104-109. Kang B.-H., Yu T., Kim J.H., Park J.M., Kim J.-I., Chung E.-J., et al. Early Closure of a Phase 1 Clinical Trial for SABR in Early-Stage Glottic Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2019;105:104-109. Sher D.J., Timmerman R.D., Nedzi L., Ding C., Pham N.-L., Zhao B., et al. Phase 1 Fractional Dose-Escalation Study of Equipotent Stereotactic Radiation Therapy Regimens for Early-Stage Glottic Larynx Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2019;105:110-118. Sher D.J., Timmerman R.D., Nedzi L., Ding C., Pham N.-L., Zhao B., et al. Phase 1 Fractional Dose-Escalation Study of Equipotent Stereotactic Radiation Therapy Regimens for Early-Stage Glottic Larynx Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2019;105:110-118. Chen H.H.W., Tsai S., Wang M., Wu. Y., Hsueh W., Yang M., et al. Experience in Fractionated Stereotactic Body Radiation Therapy Boost for Newly Diagnosed Nasopharyngeal Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2006;66;5:1408-1414. Chen H.H.W., Tsai S., Wang M., Wu. Y., Hsueh W., Yang M., et al. Experience in Fractionated Stereotactic Body Radiation Therapy Boost for Newly Diagnosed Nasopharyngeal Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2006;66;5:1408-1414. Hara W., Loo B.W., Goffinet D.R., Chang S.D., Adler J.R., Pinto H.A., et al. Excellent Local Control with Stereotactic Radiotherapy Boost after External Beam Radiotherapy in Patients with Nasopharyngeal Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2008;71;2:393-400. Hara W., Loo B.W., Goffinet D.R., Chang S.D., Adler J.R., Pinto H.A., et al. Excellent Local Control with Stereotactic Radiotherapy Boost after External Beam Radiotherapy in Patients with Nasopharyngeal Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2008;71;2:393-400. Al-Mamgani A., Tans L., Teguh D.N., van Rooij P., Zwijnenburg E.M., Levendag P.C. Stereotactic Body Radiotherapy: A Promising Treatment Option for The Boost of Oropharyngeal Cancers not Suitable for Brachytherapy: A Single-Institutional Experience. Int. J. Radiat. Oncol. Biol. Phys. 2012;82;4:1494-1500. Al-Mamgani A., Tans L., Teguh D.N., van Rooij P., Zwijnenburg E.M., Levendag P.C. Stereotactic Body Radiotherapy: A Promising Treatment Option for The Boost of Oropharyngeal Cancers not Suitable for Brachytherapy: A Single-Institutional Experience. Int. J. Radiat. Oncol. Biol. Phys. 2012;82;4:1494-1500. Lee D.S., Kim Y.S., Cheon J.S., Song J.H., Son S.H., Jang J.S., et al. Long-Term Outcome and Toxicity of Hypofractionated Stereotactic Body Radiotherapy as a Boost Treatment for Head and Neck Cancer: The Importance of Boost Volume Assessment. Radiat. Oncol. 2012;7;1:85. Lee D.S., Kim Y.S., Cheon J.S., Song J.H., Son S.H., Jang J.S., et al. Long-Term Outcome and Toxicity of Hypofractionated Stereotactic Body Radiotherapy as a Boost Treatment for Head and Neck Cancer: The Importance of Boost Volume Assessment. Radiat. Oncol. 2012;7;1:85. Ghaly M., Halthore A., Antone J., Zhang H., Cohen J., Sachs H., et al. Dose-Escalated Stereotactic Radiosurgery (Srs) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer: Phase I/II Trial. Int. J. Radiat. Oncol. Biol. Phys. 2014;90;1:S122. Ghaly M., Halthore A., Antone J., Zhang H., Cohen J., Sachs H., et al. Dose-Escalated Stereotactic Radiosurgery (Srs) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer: Phase I/II Trial. Int. J. Radiat. Oncol. Biol. Phys. 2014;90;1:S122. Yau T.K., Sze W.M., Lee W.M., Yeung M.W., Leung K.C., et al. Effectiveness of Brachytherapy and Fractionated Stereotactic Radiotherapy Boost for Persistent Nasopharyngeal Carcinoma. Head Neck. 2004;26:1024-1030. Yau T.K., Sze W.M., Lee W.M., Yeung M.W., Leung K.C., et al. Effectiveness of Brachytherapy and Fractionated Stereotactic Radiotherapy Boost for Persistent Nasopharyngeal Carcinoma. Head Neck. 2004;26:1024-1030. Wu S.X., Chua D.T., Deng M.L., Zhao C., Li F.Y., et al. Outcome of Fractionated Stereotactic Radiotherapy for 90 Patients with Locally Persistent and Recurrent Nasopharyngeal Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2007;69:761-769. Wu S.X., Chua D.T., Deng M.L., Zhao C., Li F.Y., et al. Outcome of Fractionated Stereotactic Radiotherapy for 90 Patients with Locally Persistent and Recurrent Nasopharyngeal Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2007;69:761-769. Patel P.R., Salama J.K. Reirradiation for Recurrent Head and Neck Cancer. Expert Rev. Anticancer Ther. 2012;12;9:1177-1189. Patel P.R., Salama J.K. Reirradiation for Recurrent Head and Neck Cancer. Expert Rev. Anticancer Ther. 2012;12;9:1177-1189. Goodwin W.J.Jr. Salvage Surgery for Patients with Recurrent Squamous Cell Carcinoma of the Upper Aerodigestive Tract: When Do the Ends Justify the Means? Laryngoscope. 2000;110;(3 II):1-18. Goodwin W.J.Jr. Salvage Surgery for Patients with Recurrent Squamous Cell Carcinoma of the Upper Aerodigestive Tract: When Do the Ends Justify the Means? Laryngoscope. 2000;110;(3 II):1-18. McDonald M.W., Lawson J., Garg M.K., Quon H., Ridge J.A., Saba N., et al. ACR Appropriateness Criteria Retreatment of Recurrent Head and Neck Cancer after Prior Definitive Radiation: Expert Panel on Radiation Oncology-Head and Neck Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2011;80;5:1292-1298. McDonald M.W., Lawson J., Garg M.K., Quon H., Ridge J.A., Saba N., et al. ACR Appropriateness Criteria Retreatment of Recurrent Head and Neck Cancer after Prior Definitive Radiation: Expert Panel on Radiation Oncology-Head and Neck Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2011;80;5:1292-1298. Tortochaux J., Tao Y., Tournay E., Lapeyre M., Lesaunier F., Bardet E., et al. Randomized Phase III Trial (GORTEC 98-03) Comparing Re-Irradiation Plus Chemotherapy Versus Methotrexate In Patients With Recurrent or a Second Primary Head and Neck Squamous Cell Carcinoma, Treated with a Palliative Intent. Radiother Oncol. 2011;100;1:70-75. Tortochaux J., Tao Y., Tournay E., Lapeyre M., Lesaunier F., Bardet E., et al. Randomized Phase III Trial (GORTEC 98-03) Comparing Re-Irradiation Plus Chemotherapy Versus Methotrexate In Patients With Recurrent or a Second Primary Head and Neck Squamous Cell Carcinoma, Treated with a Palliative Intent. Radiother Oncol. 2011;100;1:70-75. Lartigau E.F., Tresch E., Thariat J., Graff P., Coche-Dequeant B., Benezery K., et al. Multi Institutional Phase II Study of Concomitant Stereotactic Reirradiation and Cetuximab for Recurrent Head and Neck Cancer. Radiother. Oncol. 2013;109;2:281-285. Lartigau E.F., Tresch E., Thariat J., Graff P., Coche-Dequeant B., Benezery K., et al. Multi Institutional Phase II Study of Concomitant Stereotactic Reirradiation and Cetuximab for Recurrent Head and Neck Cancer. Radiother. Oncol. 2013;109;2:281-285. Langer C.J., Harris J., Horwitz E.M., Nicolaou N., Kies M., Curran W., et al. Phase II Study of Low-Dose Paclitaxel and Cisplatin in Combination with Split-Course Concomitant Twice-Daily Reirradiation in Recurrent Squamous Cell Carcinoma of the Head and Neck: Results of Radiation Therapy Oncology Group Protocol 9911. J. Clin. Oncol. 2007;25;30:4800-4805. Langer C.J., Harris J., Horwitz E.M., Nicolaou N., Kies M., Curran W., et al. Phase II Study of Low-Dose Paclitaxel and Cisplatin in Combination with Split-Course Concomitant Twice-Daily Reirradiation in Recurrent Squamous Cell Carcinoma of the Head and Neck: Results of Radiation Therapy Oncology Group Protocol 9911. J. Clin. Oncol. 2007;25;30:4800-4805. Voynov G., Heron D.E., Burton S., Grandis J., Quinn A., Ferris R., et al. Frameless Stereotactic Radiosurgery for Recurrent Head and Neck Carcinoma. Technol. Cancer Res. Treat. 2006;5;5:529-535. Voynov G., Heron D.E., Burton S., Grandis J., Quinn A., Ferris R., et al. Frameless Stereotactic Radiosurgery for Recurrent Head and Neck Carcinoma. Technol. Cancer Res. Treat. 2006;5;5:529-535. Heron D.E., Ferris R.L., Karamouzis M., Andrade R.S., Deeb E.L., Burton S., et al. Stereotactic Body Radiotherapy for Recurrent Squamous Cell Carcinoma of the Head and Neck: Results of a Phase I Dose-Escalation Trial. Int. J. Radiat. Oncol. Biol. Phys. 2009;75;5:1493-1500. Heron D.E., Ferris R.L., Karamouzis M., Andrade R.S., Deeb E.L., Burton S., et al. Stereotactic Body Radiotherapy for Recurrent Squamous Cell Carcinoma of the Head and Neck: Results of a Phase I Dose-Escalation Trial. Int. J. Radiat. Oncol. Biol. Phys. 2009;75;5:1493-1500. Spencer S.A., Harris J., Wheeler R.H., Machtay M., Schultz C., Spanos W., et al. Final Report of RTOG 9610, a Multi-Institutional Trial of Reirradiation and Chemotherapy for Unresectable Recurrent Squamous Cell Carcinoma of the Head and Neck. Head Neck. 2008;30;3:281-288. Spencer S.A., Harris J., Wheeler R.H., Machtay M., Schultz C., Spanos W., et al. Final Report of RTOG 9610, a Multi-Institutional Trial of Reirradiation and Chemotherapy for Unresectable Recurrent Squamous Cell Carcinoma of the Head and Neck. Head Neck. 2008;30;3:281-288. Rwigema J.C.M., Heron D.E., Ferris R.L., Andrade R.S., Gibson M.K., Yang Y., et al. The Impact of Tumor Volume and Radiotherapy Dose on Outcome in Previously Irradiated Recurrent Squamous Cell Carcinoma of the Head and Neck Treated with Stereotactic Body Radiation Therapy. Am. J. Clin. Oncol. 2011;34;4:372-379. Rwigema J.C.M., Heron D.E., Ferris R.L., Andrade R.S., Gibson M.K., Yang Y., et al. The Impact of Tumor Volume and Radiotherapy Dose on Outcome in Previously Irradiated Recurrent Squamous Cell Carcinoma of the Head and Neck Treated with Stereotactic Body Radiation Therapy. Am. J. Clin. Oncol. 2011;34;4:372-379. Vargo J.A., Ferris R.L., Ohr J., Clump D.A., Davis K.S., Duvvuri U., et al. A Prospective Phase 2 Trial of Reirradiation with Stereotactic Body Radiation Therapy Plus Cetuximab in Patients with Previously Irradiated Recurrent Squamous Cell Carcinoma of the Head and Neck. Int. J. Radiat. Oncol. Biol. Phys. 2015;91;3:480-488. Vargo J.A., Ferris R.L., Ohr J., Clump D.A., Davis K.S., Duvvuri U., et al. A Prospective Phase 2 Trial of Reirradiation with Stereotactic Body Radiation Therapy Plus Cetuximab in Patients with Previously Irradiated Recurrent Squamous Cell Carcinoma of the Head and Neck. Int. J. Radiat. Oncol. Biol. Phys. 2015;91;3:480-488. Unger K.R., Lominska C.E., Deeken J.F., Davidson B.J., Newkirk K.A., Gagnon G.J., et al. Fractionated Stereotactic Radiosurgery for Reirradiation of Head-and-Neck Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2010;77;5:1411-1419. Unger K.R., Lominska C.E., Deeken J.F., Davidson B.J., Newkirk K.A., Gagnon G.J., et al. Fractionated Stereotactic Radiosurgery for Reirradiation of Head-and-Neck Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2010;77;5:1411-1419. Cengiz M., Цzyiğit G., Yazici G., Doğan A., Yildiz F., Zorlu F., et al. Salvage Reirradiation with Stereotactic Body Radiotherapy for Locally Recurrent Head-and-Neck Tumors. Int. J. Radiat. Oncol. Biol. Phys. 2011;81;1:104-109. Cengiz M., Czyiğit G., Yazici G., Doğan A., Yildiz F., Zorlu F., et al. Salvage Reirradiation with Stereotactic Body Radiotherapy for Locally Recurrent Head-and-Neck Tumors. Int. J. Radiat. Oncol. Biol. Phys. 2011;81;1:104-109. Gebhardt B.J., Vargo J.A., Ling D., Jones B., Mohney M., Clump D.A., et al. Carotid Dosimetry and the Risk of Carotid Blowout Syndrome Following Re-Irradiation with Head and Neck Stereotactic Body Radiation Therapy. Int. J. Radiat. Oncol. Biol. Phys. 2018;101;1:195-200. Gebhardt B.J., Vargo J.A., Ling D., Jones B., Mohney M., Clump D.A., et al. Carotid Dosimetry and the Risk of Carotid Blowout Syndrome Following Re-Irradiation with Head and Neck Stereotactic Body Radiation Therapy. Int. J. Radiat. Oncol. Biol. Phys. 2018;101;1:195-200. Kong L., Hu J., Guan X., Gao J., Lu R., Lu J.J. Phase I/II Trial Evaluating Carbon Ion Radiotherapy for Salvaging Treatment of Locally Recurrent Nasopharyngeal Carcinoma. J. Cancer. 2016;7;7:774-783. Kong L., Hu J., Guan X., Gao J., Lu R., Lu J.J. Phase I/II Trial Evaluating Carbon Ion Radiotherapy for Salvaging Treatment of Locally Recurrent Nasopharyngeal Carcinoma. J. Cancer. 2016;7;7:774-783. Romesser P.B., Cahlon O., Scher E.D., Hug E.B., Sine K., Deselm C., et al. Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-Institutional Report on Feasibility and Early Outcomes. Int. J. Radiat. Oncol. Biol. Phys. 2016;95;1:386-395. Romesser P.B., Cahlon O., Scher E.D., Hug E.B., Sine K., Deselm C., et al. Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-Institutional Report on Feasibility and Early Outcomes. Int. J. Radiat. Oncol. Biol. Phys. 2016;95;1:386-395. McDonald M.W., Zolali-Meybodi O., Lehnert S.J., Estabrook N.C., Liu Y., Cohen-Gadol A.A., et al. Reirradiation of Recurrent and Second Primary Head and Neck Cancer with Proton Therapy. Int. J. Radiat. Oncol. Biol. Phys. 2016;96;4:808-819. McDonald M.W., Zolali-Meybodi O., Lehnert S.J., Estabrook N.C., Liu Y., Cohen-Gadol A.A., et al. Reirradiation of Recurrent and Second Primary Head and Neck Cancer with Proton Therapy. Int. J. Radiat. Oncol. Biol. Phys. 2016;96;4:808-819.