Oligometastatic squamous cell carcinoma treated with and without involved site radiation

Comprising a heterogenous population, the optimal management of oligometastatic head and neck cancer is uncertain. We sought to report outcomes among patients treated with and without stereotactic body radiotherapy (SBRT) to local sites of disease. A review of institutional registries identified 49 patients with metastatic squamous cell carcinoma of the head and neck limited to 5 sites of disease or less. Patients with intact disease at primary local-regional sites; those treated by palliative radiation; and those who had previously received first-line systemic therapy were excluded. A total of 20 patients met eligibility criteria. Treatment included systemic therapy alone (10 patients) and systemic therapy with SBRT (10 patients). The median progression-free survival was 11 months and 6 months, respectively (p=0.09). The 2-year overall survival was 29% and 15% for patients treated by SBRT and systemic therapy compared to systemic therapy alone, respectively (p=0.21). There were no differences in the development of grade 3+ toxicity between the 2 groups, with the incidence of grade 3+ toxicity being 20% and 30% for patients treated with and without SBRT, respectively (p=0.61). Local SBRT was associated with trends in improved progression-free survival among patients with oligometastatic head and neck cancer. Prospective studies with larger datasets are warranted to further evaluate the role of this modality in this setting. • Significant variability exists in the management of oligometastatic head and neck cancer. • Local stereotactic body radiotherapy (SBRT) was associated with trends in improved progression-free survival among patients with oligometastatic head and neck cancer. • No difference in the incidence of acute toxicity was observed between patients treated with and without local SBRT.