Salvage Stereotactic Re-irradiation with CyberKnife for Locally Recurrent Head and Neck Cancer: A Single Center Experience. Issue 3 (May 2014)

• Record Type: Journal Article
• Authors: Bonomo, Pierluigi; Cipressi, Samantha; Iermano, Carmine; Bonucci, Ivano; Masi, Laura; Doro, Raffaela; Favuzza, Virginia; Paiar, Fabiola; Simontacchi, Gabriele; Meattini, Icro; Greto, Daniela; Agresti, Benedetta; Livi, Lorenzo; Biti, Giampaolo
• Is Part Of: Tumori. Volume 100:Issue 3(2014)
• Page Start: 278
• Page End: 283
• Publication Date: 2014-05
• Subjects: head and neck cancer -- local-regional recurrence -- radiotherapy; Cancer -- Periodicals; 616.994
• DOI: 10.1700/1578.17202
• Languages: English
• ISSNs: 0300-8916

Abstract

Aims and Background: We report the toxicity and preliminary clinical outcome in patients affected by locally recurrent head and neck cancer treated with stereotactic reirradiation. Methods: Between February 2012 and August 2013, 17 patients were treated with CyberKnife as stereotactic re-irradiation for locally recurrent head and neck cancer. All patients had previously received a full dose radiation treatment with radical intent, with a median total dose of 66 Gy (range, 50–70) delivered with standard fractionation. The median interval between the primary radiotherapy and re-irradiation was 24 months (range, 10–168). Results: All patients completed the prescribed treatment, which was delivered in 5 fractions. The median tumor dose administered was 30 Gy (range, 25–35) prescribed to the 80% isodose line. Treatment sites were as follows: neck lymph nodes in 5 patients, paranasal sinuses in 5, oropharynx in 2, nasopharynx, and larynx, oral cavity, nasal fossa and parotid gland each in 1 patient. The median target volume treated was 58.7 cm 3 (range, 8.5–211.3). Sixteen patients (94%) were evaluated for response. At a median follow-up of 7.5 months (range, 2–17), 4 patients achieved complete response (25%), 5 had partial response (31%) and 7 showed stable disease (44%). No patient showed in-field progression after re-irradiation. Grade 3 acute toxicity was noted in one patient only; no late side effect was observed during the follow-up. Conclusions: Stereotactic re-irradiation with CyberKnife is an appealing non-surgical salvage treatment for selected patients with local-regionally recurrent head and neck cancer.