Outcome of Fractionated Stereotactic Radiotherapy for 90 Patients With Locally Persistent and Recurrent Nasopharyngeal Carcinoma

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

“…Stereotactic radiosurgery has been accepted as an effective model with high dose delivery option; however, high risk of toxicity remains a challenging problem (Chua et al, 2003;Low et al, 2006;Wu et al, 2007). The rapid dose falloff at target periphery enables to protect close critical structures while giving high doses of radiation to the target.…”

Safe and Curative Brachytherapy Reirradiation with Organ-Sparing Hyaluronate Gel Injection

“…Several authors reported the effectiveness of reirradiation by external beam [Okamoto, 2002;Oksuz, 2004;Sulman, 2008;Wu, 2007;Wurschmidt, 2008] with a relatively small incidence of grade 3-4 toxicity for a cumulative dose of 110-117 Gy, where the median intervals ranged from 13 to 92 months. However we must be careful to apply some idea of interval repair because an individual tissue tolerance differs not only by the dose and the interval.…”

“…In radiotherapy, sufficient dose delivery promises local cure [Hayashi, 2002;Okamoto, 2002;Wu, 2007] and reirradiation is as effective as the first radiotherapy. Dose dependency of the effect is also reported in reirradiation [Damast, 2010].…”

“…In the clinical situation, however, the use of reirradiation is limited because of the low tolerance level of surrounding normal tissue . A significant incidence of late toxicity attributable to accumulated dose in various at-risk organs is reported [Salama, 2006;Wu, 2007]. In a survey of the attitudes of radiation oncologists, only one third (90 of 271) of participants responded that they would consider reirradiation for in-field failure after previous radical radiotherapy [Joseph, 2008].…”

Stereotactic body radiation therapy in head and neck, gynecologic, and pediatric malignancies

“…Previously stereotactic radiosurgery using gamma-knife or linear accelerators was only used in intracranial or base of skull lesions as these sites were amenable to rigid frame-based stereotactic localization. Indeed, large experience exists with the use of SBRT in nasopharyngeal cancers as a boost treatment or for recurrent lesions [13][14][15][16][17][18][19][20][21]. However, the parallel development and prevalence of new technologies such as kilovoltage and megavoltage conebeam CT scans, Cyberknife imaging, CT-on-rails, etc.…”