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The standard approach for metastatic squamous cell carcinoma of the head and neck (SCCHN) has been systemic chemotherapy, although it is associated with significant toxicity and quality-of-life (QoL) deterioration. For patients with oligometastatic disease — an intermediate clinical state between locoregional and widely metastatic cancer — targeted therapies such as stereotactic ablative radiation therapy (SABR) may provide prolonged survival with more-acceptable toxicity. In this phase 2 trial (NCT03070366), 69 patients with SCCHN and one to three oligometastases were randomized to either SABR alone or with chemotherapy (5-fluorouracil, platinum, cetuximab).
The primary endpoint — 1-year overall survival (OS) without QoL deterioration — was…