Hypofractionated stereotactic radiotherapy using CyberKnife as a boost treatment for head and neck cancer, a multi-institutional survey: impact of planning target volume

To evaluate the role of hypofractionated stereotactic radiotherapy (hSRT) as a boost treatment for head and neck cancer. 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....

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Bibliographic Details
Published in:Anticancer research 2014-10, Vol.34 (10), p.5755-5759
Main Authors: Yamazaki, Hideya, Ogita, Mikio, Himei, Kengo, Nakamura, Satoaki, Yoshida, Ken, Kotsuma, Tadayuki, Yamada, Yuji, Fujiwara, Masateru, Baek, Sungjae, Yoshioka, Yasuo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Dose Fractionation
Female
Follow-Up Studies
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - mortality
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - surgery
Humans
Male
Middle Aged
Neoplasm Staging
Prognosis
Radiosurgery
Radiotherapy Planning, Computer-Assisted
Treatment Outcome
Young Adult
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Summary:To evaluate the role of hypofractionated stereotactic radiotherapy (hSRT) as a boost treatment for head and neck cancer. 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). 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. The results of the present study showed potential benefits of the CyberKnife hSRT boost. Smaller PTV and good initial response predict good outcome.
ISSN:0250-7005
1791-7530