Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Dizman, Aysen; Coskun-Breuneval, Mehtap; Altinisik-Inan, Gonca; Olcay, Gokce Kaan; Cetindag, Mehmet Faik; Guney, Yildiz

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자료유형: 학술저널

저자정보: Dizman, Aysen (Radiation Oncology, Ankara Oncology Hospital) Coskun-Breuneval, Mehtap (Radiation Oncology, Ankara Oncology Hospital) Altinisik-Inan, Gonca (Radiation Oncology, Ankara Oncology Hospital) Olcay, Gokce Kaan (Radiation Oncology, Ankara Oncology Hospital) Cetindag, Mehmet Faik (Radiation Oncology, Ankara Oncology Hospital) Guney, Yildiz (Radiation Oncology, Ankara Oncology Hospital)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제8호

발행연도: 2014.1

수록면: 3,561 - 3,566 (6page)

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Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.

#Recurrent nasopharyngeal carcinoma #stereotactic radiotherapy #CyberKnife

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