High-dose stereotactic radiotherapy boost in the treatment of squamous cell carcinoma of the head and neck region

Abstract

Background Surgical resection with adjuvant concurrent radiochemotherapy is the standard of care for stage III–IV oral cavity cancer. In some cases, the dynamic course of the disease is out of the prepared schedule of treatment. In that event, a stereotactic radiosurgery boost might be the only chance for disease control. Case presentation Here, we present a case study of a patient with oral cancer who underwent surgery. During adjuvant radiotherapy, a metastatic cervical lymph node was diagnosed based on fine-needle aspiration biopsy. To increase the total dose to the metastatic tumor, a stereotactic radiosurgery boost of 1 × 18 Gy was performed two days after the last fraction of conventional radiotherapy. The early and late tolerance of this treatment were positive. During the 18-month follow-up, locoregional recurrence was not detected. The patient died due to secondary malignancy. Conclusions This paper shows that a stereotactic radiosurgery boost added to adjuvant conventional radiotherapy is an effective approach permitting the maintenance of good local control in well-selected patients.

Stereotactic Radiotherapy Boost in Treatment of Persistent Periocular Sebaceous Carcinoma after Surgery

“…The combined biological effective dose was 98.4 Gy (72 Gy from conventional radiotherapy and 26.4 Gy from the stereotactic radiotherapy boost). Our previous experiences, which considered using a stereotactic radiotherapy boost on patients with adenoid cystic carcinoma and squamous cell carcinoma confirm the usefulness of such an approach in the radioresistant or dynamic course of cancer [ 9 , 10 ]. Early and late toxicities in those cases and in the case of the presented patient were acceptable; however, the application of a stereotactic radiotherapy boost needs very careful qualification and further clinical studies.…”

Survival Benefit from Cancer‐Directed Surgery for Metastatic Head and Neck Cancer

“…With the development of modern radiotherapy techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), the efficacy of radiotherapy in treating M1 HNC has significantly improved in the past 20 years. [37][38][39][40][41] This is mainly because IMRT and SBRT allow the administration of larger radiation doses with sparing of normal tissues and provide good locoregional control (LRC) in well-selected patients. Consistent with the findings of the above study, our research also discovered that patients who received CDS followed by adjuvant radiotherapy had better overall and HNC-specific survival than those who received CDS alone.…”

“…Adjuvant radiotherapy is an important treatment modality for patients with M1 HNC, and it has attracted a lot of attention from researchers in recent years. With the development of modern radiotherapy techniques such as intensity‐modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), the efficacy of radiotherapy in treating M1 HNC has significantly improved in the past 20 years 37–41 . This is mainly because IMRT and SBRT allow the administration of larger radiation doses with sparing of normal tissues and provide good locoregional control (LRC) in well‐selected patients.…”