Stereotactic body radiotherapy (SBRT) is characterized by a high dose per fraction, well-defined small targets, superior dose conformity, and a steep off-target dose gradient. A literature search was conducted to examine the experience with SBRT as a curative treatment for newly diagnosed mucosal carcinoma of the head and neck (MCHN). Four retrospective case series and one prospective phase I clinical trial published between 2012 and 2020 described 124 patients. SBRT was mainly performed in older patients with different tumor sites. The median size of the planning target volumes ranged from 5.3 to 41 cm3. Different approaches were used to create margins. In two studies, limited elective nodal irradiation was performed. The equivalent doses used were 60–83.33 Gy delivered in five fractions. Considerable heterogeneity was observed in the radiation dose specification. The incidence of grade ≥3 late toxicity was 0–8.3%, with local and regional control ranging from 73% to 100%. Improved or stable quality of life after SBRT was reported in two studies. Curative-intent SBRT for de novo MCHN appears to be an effective and relatively safe treatment for small tumor targets, preferably without concomitant elective tissue irradiation. Standardization of SBRT practice and well-designed prospective clinical trials are needed to better define the role of SBRT in this setting.
立体定向放射治疗（SBRT）具有单次分割剂量高、靶区界定清晰、剂量适形性优及靶区外剂量梯度陡峭等特点。本文通过文献检索，探讨SBRT作为初诊头颈部黏膜癌（MCHN）根治性治疗手段的临床经验。2012年至2020年间发表的4项回顾性病例系列研究和1项前瞻性I期临床试验共纳入124例患者。SBRT主要应用于不同肿瘤部位的老年患者，计划靶区体积中位值范围为5.3至41 cm³。各研究采用不同的边界设定方法，其中两项研究实施了有限的选择性淋巴结照射。治疗等效剂量为60-83.33 Gy，分5次完成。放射剂量规范存在显著异质性。≥3级晚期毒性发生率为0-8.3%，局部及区域控制率达73%至100%。两项研究报告SBRT后生活质量改善或保持稳定。对于初诊MCHN的小型肿瘤靶区，根治性SBRT（尤其在不联合选择性组织照射时）显示出有效且相对安全的治疗效果。未来需通过规范SBRT临床实践和完善前瞻性临床试验设计，进一步明确SBRT在该领域的治疗价值。
肿瘤(癌症)患者之家