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Background <p>The current results of head and neck cancer treatment remain suboptimal therefore, novel approaches are needed to improve its effectiveness. This prospective, single-center study aims to assess the results and safety of combining conventionally fractionated radiotherapy with a high-dose stereotactic radiotherapy boost in radical treatment.</p> Methods <p>Twenty-eight patients with head and neck tumors of diverse localizations and histopathologies were recruited. The stereotactic boost was delivered to primary tumors or metastatic nodes up to 6 days before or after conventional radiotherapy. The boost doses ranged from 8 to 18&#xa0;Gy.</p> Results <p>A complete response was observed in 25 patients (89%). The response did not depend on boost size or its timing within the regimen. Disease progression caused death in 5 cases. Positive surgical margins increased the risk of metastasis eighteenfold (<i>p</i> = 0.015) and mortality threefold (<i>p</i> = 0.030). A higher Zubrod performance status correlated with greater acute mucosal and skin toxicity. The most severe late complications were carotid blow-out syndrome (with actinomycosis coinfection) and brain necrosis. The risk of late toxicity increased after exceeding a biological effective dose of 143.33&#xa0;Gy (<i>p</i> = 0.0148).</p> Conclusions <p>A boost with a dose of 10&#xa0;Gy represents a promising treatment option with permissible tolerance, with higher doses offering similar efficacy but greater late toxicity.</p> Trial registration <p>The study protocol was approved by the local Bioethics Committee (KB/430 − 87/19) and registered on the ClinicalTrials.gov (NCT06472570) on 25 June 2024.</p>

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High-dose stereotactic radiotherapy boost in the radical treatment of head and neck tumors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月29日

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  • Paweł Polanowski,
  • Andrzej Tukiendorf,
  • Aleksandra Nasiek,
  • Aleksandra Grządziel,
  • Agnieszka Pietruszka,
  • Katarzyna Polanowska,
  • Tomasz Rutkowski,
  • Krzysztof Składowski

摘要

Background

The current results of head and neck cancer treatment remain suboptimal therefore, novel approaches are needed to improve its effectiveness. This prospective, single-center study aims to assess the results and safety of combining conventionally fractionated radiotherapy with a high-dose stereotactic radiotherapy boost in radical treatment.

Methods

Twenty-eight patients with head and neck tumors of diverse localizations and histopathologies were recruited. The stereotactic boost was delivered to primary tumors or metastatic nodes up to 6 days before or after conventional radiotherapy. The boost doses ranged from 8 to 18 Gy.

Results

A complete response was observed in 25 patients (89%). The response did not depend on boost size or its timing within the regimen. Disease progression caused death in 5 cases. Positive surgical margins increased the risk of metastasis eighteenfold (p = 0.015) and mortality threefold (p = 0.030). A higher Zubrod performance status correlated with greater acute mucosal and skin toxicity. The most severe late complications were carotid blow-out syndrome (with actinomycosis coinfection) and brain necrosis. The risk of late toxicity increased after exceeding a biological effective dose of 143.33 Gy (p = 0.0148).

Conclusions

A boost with a dose of 10 Gy represents a promising treatment option with permissible tolerance, with higher doses offering similar efficacy but greater late toxicity.

Trial registration

The study protocol was approved by the local Bioethics Committee (KB/430 − 87/19) and registered on the ClinicalTrials.gov (NCT06472570) on 25 June 2024.