A Retrospective Comparison of Robotic Stereotactic Body Radiotherapy and Three-Dimensional Conformal Radiotherapy for the Reirradiation of Locally Recurrent Nasopharyngeal Carcinoma

Özyiğit, Gökhan; Cengiz, Mustafa; Yazıcı, Gözde; Yıldız, Ferah; Gurkaynak, M.; Zorlu, Faruk; Yıldız, Demet; Hoşal, Şefik; Güllü, İbrahi̇m; Akyol, Fadıl

doi:10.1016/j.ijrobp.2011.02.054

Cited by 56 publications

(33 citation statements)

References 17 publications

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“…Another study that included 36 patients with recurrent head and neck cancer that were re-irradiated with a median dose of 30 Gy in 3–5 fractions reported that the 1-year local control rate was 61%, but that grade 3 or higher side effects occurred in 37% of patients 3 . In an earlier study we compared 3D-CRT and SBRT in 51 recurrent nasopharyngeal cancer patients; the 2-year local control rate was similar in both groups (80% versus 82%), but serious late effects were significantly less common in the SBRT group (48% versus 21%, P < 0.05) [15]. Furthermore we noticed that fatal CBOS rates were much higher than the previously reported reirradiation series [16-18].…”

Section: Discussionmentioning

confidence: 75%

A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers

et al. 2013

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BackgroundThis study aimed to compare the therapeutic outcomes and fatal carotid blow out syndrome (CBOS) incidence rates between two different stereotactic body radiotherapy (SBRT) protocols.MethodsThe study included 75 patients with inoperable locally recurrent head and neck cancer treated with SBRT in our department between June 2007 and March 2011. The first 43 patients were treated sequentially (group I). Then our SBRT protocol was changed due to the high rate of CBOS, and the following 32 patients were treated every other day in a prospective institutional protocol (group II).ResultsMedian overall survival in group I and group II was 11 months and 23 months, respectively (P = 0.006). We observed 11 cases of CBOS. Only 1 of 7 patients (14%) with CBOS survived in group I, whereas 2 of 4 patients (50%) in group II remain alive. CBOS free median overall survivals were 9 months, and 23 months in group I and group II respectively (P = 0.002). The median radiation dose received by the carotid artery in patients with CBOS was 36.5 Gy (range: 34–42.8 Gy), versus 34.7 Gy (range: 0–44 Gy) in the patients that didn’t have CBOS (P = 0.15). CBOS did not occur in any of the patients with a maximum carotid artery radiation dose <34 Gy.ConclusionsEvery other day SBRT protocol for re-irradiation of recurrent head and neck cancer is promising in terms of decreasing the incidence of fatal CBOS.

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Section: Discussionmentioning

confidence: 75%

A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers

et al. 2013

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“…The majority of late grade 3 toxicity was feeding-tube related, although 7% of patients required surgical intervention for radiation necrosis and two suffered carotid blowouts. It is difficult to directly compare toxicity rates between series due to differences in scales and reporting, but generally late grade 3 or greater toxicity appears to be decreasing with improved radiotherapy technique [26–28]. Also, as it has become clear that most failures are in-field, margin reduction with better setup techniques (i.e., image guided radiotherapy) should lead to smaller fields and further reduction in late complications [29,30].…”

Section: Discussionmentioning

confidence: 99%

A nomogram to predict loco-regional control after re-irradiation for head and neck cancer

Riaz

Hong

Sherman

et al. 2014

Radiotherapy and Oncology

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Background and purpose Loco-regionally recurrent head and neck cancer (HNC) in the setting of prior radiotherapy carries significant morbidity and mortality. The role of re-irradiation (re-RT) remains unclear due to toxicity. We determined prognostic factors for loco-regional control (LRC) and formulated a nomogram to help clinicians select re-RT candidates. Material and methods From July 1996 to April 2011, 257 patients with recurrent HNC underwent fractionated re-RT. Median prior dose was 65 Gy and median time between RT was 32.4 months. One hundred fifteen patients (44%) had salvage surgery and 172 (67%) received concurrent chemotherapy. Median re-RT dose was 59.4 Gy and 201 (78%) patients received IMRT. Multivariate Cox proportional hazards were used to identify independent predictors of LRC and a nomogram for 2-year LRC was constructed. Results Median follow-up was 32.6 months. Two-year LRC and overall survival (OS) were 47% and 43%, respectively. Recurrent stage (P = 0.005), non-oral cavity subsite (P < 0.001), absent organ dysfunction (P < 0.001), salvage surgery (P < 0.001), and dose >50 Gy (P = 0.006) were independently associated with improved LRC. We generated a nomogram with concordance index of 0.68. Conclusion Re-RT can be curative, and our nomogram can help determine a priori which patients may benefit.

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“…In the reported reirradiation studies except those with BT alone, the majority of the recurrences are at advanced stage with a ratio of 15-73.3% and 8-53% for rT3-4 tumor and rStage-4 diseases, respectively (Lee et al, 1997;Xiao et al, 2001;Lu et al, 2004;Chua et al, 2005;Wu et al, 2007;Seo et al, 2009;Koutcher et al, 2010;Ozyigit et al, 2011). In our series the 41.7% of the cases were with rT3-4 and 29.2% were with rStage-4 disease.…”

Section: Discussionmentioning

confidence: 46%

“…In our series the 41.7% of the cases were with rT3-4 and 29.2% were with rStage-4 disease. Recurrent tumor T stage has been presented as a prognostic factor in many previously reported series (Chua et al, 2005;Oksuz et al, 2009;Koutcher et al, 2010;Ozyigit et al, 2011;El-Sherbieny et al, 2011;Sun et al, 2012) . The poor outcome with advanced rT lesions may be related to poor target coverage due to nearby critical structures.…”

Section: Discussionmentioning

confidence: 99%

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Dizman¹,

Coskun-Breuneval²,

Altinisik-Inan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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A Retrospective Comparison of Robotic Stereotactic Body Radiotherapy and Three-Dimensional Conformal Radiotherapy for the Reirradiation of Locally Recurrent Nasopharyngeal Carcinoma

Cited by 56 publications

References 17 publications

A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers

A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers

A nomogram to predict loco-regional control after re-irradiation for head and neck cancer

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

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