Current literature regarding survival and treatment outcome of SBRT in patients with pulmonary oligometastatic head and neck squamous cell carcinoma (HNSCC) is limited. Additionally, most of the published studies include metastatic lesions deriving also from primaries with histologies other than SCC when investigating the outcome of SBRT. The aim of the present retrospective study is to explore local control (LC) of treated metastases, progression-free survival (PFS), and overall survival (OS) of exclusively pulmonary oligometastatic HNSCC-patients treated with SBRT. Between 2006 and 2021, a total of 46 patients were treated with SBRT for a maximum of four pulmonary oligometastases (PM) concurrently (mean PM per patient = 2.0; range 1 to 6 PM, total of 92). Of these, 17 patients (37.0%) developed new pulmonary metastases after their first SBRT. Repeated courses of SBRT were required once in 15 patients (88.2%) and twice in 2 patients (11.8%). Median follow-up was 17 months (range, 0–109 months). One year after completion of SBRT, LC rate, PFS, and OS were 98.7%, 37.9%, and 79.5%, respectively. After two years, LC rate, PFS, and OS were 98.7%, 28.7%, and 54.9%; as well as 98.7%, 16.7%, and 31.0% after five years. Radiochemotherapy (HR 2.72,p< 0.001) or radiotherapy as primary treatment (HR 8.60;p= 0.003), as well as reduced patient performance status (HR 48.30,p= 0.002), were associated with lower PFS. Inferior OS correlated with poor performance status (HR 198.51,p< 0.001) and surgery followed by radiochemotherapy (HR 4.18,p= 0.032) as primary treatment, as well as radiotherapy alone (HR 7.11,p= 0.020). Treatment of more than one PM is an independent predictor of impaired OS (HR 3.30,p= 0.016). SBRT of HNSCC-derived PMs results in excellent LC rates and encouraging OS rates of 54.9% at two years along with good tolerability (no more than grade 2 toxicities). Favourable outcome and low toxicity also apply to repeated courses of SBRT of newly emerging PMs.
目前关于立体定向放射治疗（SBRT）在肺寡转移头颈部鳞状细胞癌（HNSCC）患者中生存与治疗结局的文献较为有限。此外，多数已发表研究在探讨SBRT疗效时，常纳入除鳞癌外其他组织学类型原发灶来源的转移灶。本回顾性研究旨在专门探讨接受SBRT治疗的肺寡转移HNSCC患者的转移灶局部控制率（LC）、无进展生存期（PFS）及总生存期（OS）。2006年至2021年间，共46例患者因最多四个同期肺寡转移灶（PM）接受SBRT治疗（人均PM数=2.0；范围1-6个PM，总计92个）。其中17例患者（37.0%）在首次SBRT后出现新发肺转移灶，15例（88.2%）需接受单次重复SBRT疗程，2例（11.8%）需接受两次重复疗程。中位随访时间为17个月（范围0-109个月）。SBRT完成后1年，LC率、PFS率及OS率分别为98.7%、37.9%和79.5%；2年后分别为98.7%、28.7%和54.9%；5年后分别为98.7%、16.7%和31.0%。放化疗（HR 2.72，p<0.001）或单纯放疗作为初始治疗（HR 8.60，p=0.003），以及患者体能状态下降（HR 48.30，p=0.002）与较低PFS相关。较差的OS与体能状态不佳（HR 198.51，p<0.001）、手术序贯放化疗（HR 4.18，p=0.032）及单纯放疗（HR 7.11，p=0.020）作为初始治疗相关。治疗超过一个PM是OS受损的独立预测因素（HR 3.30，p=0.016）。SBRT治疗HNSCC来源的PM可获得优异的LC率，2年OS率达54.9%且耐受性良好（仅出现≤2级毒性）。对于新发PM的重复SBRT疗程，同样展现出良好疗效与低毒性特征。
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