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CONCLUSION
Despite limited evidence, due to the retrospective nature of the data, some conclusions can be drawn. In mHNC, although chemotherapy is considered the standard treatment, RT offers a high chance of palliation. In metastatic patients with a good PS, a high-dose regimen could be used after careful patient selection. In oligometastatic disease, some clinical settings should be considered for a more curative approach. In patients with a controlled primary tumor that present favorable prognostic factors, such as a high KPS (≥80) and a limited number of metastases, a radical approach with SBRT should be considered. In the presence of locoregional recurrence, it is unknown whether treatment over the primary tumor is indicated. However, particularly in HPV+ patients, after a consideration of prognostic factors, local treatment with RT might be appropriate. Not enough data are available to recommend this approach for HPV− patients. Those with NPC with a limited number of metastases, particularly those with bone metastases, might be candidates for a radical approach to metastasis with SBRT. Retrospective data indicate that in mNPC patients with primary tumor recurrence and a limited number of metastases, treatment of the primary tumor with RT might be also indicated. Prospective studies are needed to identify which metastatic patients may benefit from a radical approach with RT.
Disclosure
The authors report no conflicts of interest in this work.
Rafael Ordoñez, Ana Otero, Inmaculada Jerez, Jose .A Medina, Yolanda Lupiañez-Pérez, Jaime Gomez-Millan
Department of Radiation Oncology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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Source: OncoTargets and Therapy
Originally published January 18, 2019.
