Hideya Yamazaki1, Mikio Ogita2, Kengo Himei3, Satoaki Nakamura4, Ken Yoshida5, Tadayuki Kotsuma5, Yuji Yamada6, Masateru Fujiwara7, Sungjae Baek7, Yasuo Yoshioka8. 1. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan CyberKnife Center, Soseikai General Hospital, Kyoto, Japan hideya10@hotmail.com. 2. Radiotherapy Department, Fujimoto Hayasuzu Hospital, Miyazaki, Japan. 3. Department of Radiology, Japanese Red cross Okayama Hospital, Okayama, Japan. 4. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. 5. Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 6. Department of Radiation Oncology, NTT West Japan Osaka Hospital, Osaka, Japan. 7. Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 8. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan CyberKnife Center, Soseikai General Hospital, Kyoto, Japan Radiotherapy Department, Fujimoto Hayasuzu Hospital, Miyazaki, Japan Department of Radiology, Japanese Red cross Okayama Hospital, Okayama, Japan Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan Department of Radiation Oncology, NTT West Japan Osaka Hospital, Osaka, Japan Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Abstract
AIM: To evaluate the role of hypofractionated stereotactic radiotherapy (hSRT) as a boost treatment for head and neck cancer. PATIENTS AND METHODS: We conducted a multi-institutional retrospective review for the outcome of boost irradiation using CyberKnife for head and neck cancer patients from the charts of four Institutes. Twenty-five patients were treated with hSRT boost for primary site with a median follow-up of 28 months. Treatment sites were 11 nasopharynx, 7 oropharynx, one hypopharynx, 3 nasal cavity or paranasal sinus and three oral cancers. All patients underwent preceding conventional radiotherapy of 35 to 72 Gy (median, 50 Gy) in 1.2- to 2 Gy-fractions. The dose and fractionation scheme of the Cyberknife SRT boost was individualized and the prescribed dose ranged from 12 Gy to 35 Gy in 1 to 5 fractions (median, 15 Gy in 3 fractions). RESULTS: There were 18 complete responses, 6 partial responses and one progressive disease, resulting in 96% (24/25) response rate. Local control (LC) rates at 2- and 5-years were 89% and 71%, respectively. Progression-free survival (PFS) and overall survival (OS) at 2- and 5-years were 70%/ 83% and 70%/ 70%, respectively. Planning target volume (PTV) at boost treatment planning and initial response were predisposing factors for PFS and OS. Patients with PTV ≤ 20 cm(3) showed better PFS (92%) and OS (100%) than those with a PTV > 20 cm(3) (PFS, 61% and OS, 47%). Good initial response predicts better outcome in LC, PFS and OS. CONCLUSION: The results of the present study showed potential benefits of the CyberKnife hSRT boost. Smaller PTV and good initial response predict good outcome. Copyright
AIM: To evaluate the role of hypofractionated stereotactic radiotherapy (hSRT) as a boost treatment for head and neck cancer. PATIENTS AND METHODS: We conducted a multi-institutional retrospective review for the outcome of boost irradiation using CyberKnife for head and neck cancerpatients from the charts of four Institutes. Twenty-five patients were treated with hSRT boost for primary site with a median follow-up of 28 months. Treatment sites were 11 nasopharynx, 7 oropharynx, one hypopharynx, 3 nasal cavity or paranasal sinus and three oral cancers. All patients underwent preceding conventional radiotherapy of 35 to 72 Gy (median, 50 Gy) in 1.2- to 2 Gy-fractions. The dose and fractionation scheme of the Cyberknife SRT boost was individualized and the prescribed dose ranged from 12 Gy to 35 Gy in 1 to 5 fractions (median, 15 Gy in 3 fractions). RESULTS: There were 18 complete responses, 6 partial responses and one progressive disease, resulting in 96% (24/25) response rate. Local control (LC) rates at 2- and 5-years were 89% and 71%, respectively. Progression-free survival (PFS) and overall survival (OS) at 2- and 5-years were 70%/ 83% and 70%/ 70%, respectively. Planning target volume (PTV) at boost treatment planning and initial response were predisposing factors for PFS and OS. Patients with PTV ≤ 20 cm(3) showed better PFS (92%) and OS (100%) than those with a PTV > 20 cm(3) (PFS, 61% and OS, 47%). Good initial response predicts better outcome in LC, PFS and OS. CONCLUSION: The results of the present study showed potential benefits of the CyberKnife hSRT boost. Smaller PTV and good initial response predict good outcome. Copyright
Authors: Krysta L Gasser Rutledge; Kumar G Prasad; Kara R Emery; Anthony A Mikulec; Mark Varvares; Michael Anne Gratton Journal: Ann Otol Rhinol Laryngol Date: 2015-06-17 Impact factor: 1.547