Intensity-modulated radiotherapy with planned Gamma Knife radiosurgery boost for head and neck cancer with extensive disease in proximity to critical structures.

Autor: Farris JC; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Steber CR; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Black PJ; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Chan MD; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Ververs JD; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Cramer CK; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Browne JD; Department Otolaryngology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Waltonen JD; Department Otolaryngology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Sullivan CA; Department Otolaryngology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Patwa HS; Department Otolaryngology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Laxton AW; Department of Neurosurgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Tatter SB; Department of Neurosurgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Frizzell BA; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Porosnicu M; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.; Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Lycan TW; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.; Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Greven KM; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., Hughes RT; Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2022 Nov; Vol. 44 (11), pp. 2571-2578. Date of Electronic Publication: 2022 Sep 01.
DOI: 10.1002/hed.27176
Abstrakt: Background: To describe intensity-modulated radiotherapy (IMRT) with Gamma Knife Radiosurgery (GKRS) boost for locally advanced head and neck cancer (HNC) with disease near dose-limiting structures.
Methods: Patients with HNC treated with IMRT/GKRS as part of a combined modality approach between 2011 and 2021 were reviewed. Local control, overall survival and disease-specific survival were estimated using the Kaplan Meier method.
Results: Twenty patients were included. Nineteen patients had T3-4 tumors. Median follow-up was 26.3 months. GKRS site control was 95%. Two patients progressed at the treated primary site, one patient failed at the edge of the GKRS treatment volume, with no perineural or intracranial failure. 2-year OS was 94.7% (95% CI: 85.2%-100%). Concurrent chemotherapy was given in nine patients (45%). One patient (5%) received induction/concurrent chemotherapy. Brain radionecrosis occurred in three patients, one of which was biopsy-proven.
Conclusions: IMRT plus GKRS boost results in excellent disease control near critical structures with minimal toxicity.
(© 2022 The Authors. Head & Neck published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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