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Preliminary results of CyberKnife stereotactic radiotherapy (SBRT) boost for primary head and neck cancers: is it the future direction?

Published online by Cambridge University Press:  14 January 2015

Tejinder Kataria
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Trinanjan Basu
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Shikha Goyal
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Ashu Abhishek
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Deepak Gupta
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Vikraman Subramani
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
K. P. Karrthick
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Shyam S. Bisht
Affiliation:
Division of Radiation Oncology, Medanta Cancer Institute, Medanta The Medicity, Gurgaon, India
Corresponding

Abstract

Aim

To analyse the preliminary results of CyberKnife stereotactic radiotherapy (SBRT) boost in primary head and neck cancer patients among Indian population.

Methods and materials

A total of nine patients of primary head and neck cancer were treated with CyberKnife SBRT boost after intensity-modulated radiation therapy (IMRT). The median phase 1 IMRT dose was 54 Gy/27 fractions. Histological types included squamous cell carcinoma (n=7) and adenoid cystic carcinoma (n=2). Response was evaluated using positron emission tomography/computed tomography and detailed clinical examination.

Results

As a preliminary analysis with median follow up of 8 months (range: 6–19 months), phase 2 median tumour volume of 16·3 cc and a median dose of 5 Gy per fraction, eight patients had loco-regionally stable disease and one had distant metastasis. With objective assessment five patients had complete response. Treatment was well tolerated with no grade 3 or more acute toxicities directly related to CyberKnife boost.

Conclusion

CyberKnife SBRT boost is an attractive option for primary head and neck cancers especially where disease is in close proximity to critical structures hindering radical dose delivery. Future prospective analysis and optimum assessment of total biological effective dose (BED) in a properly selected case might actually benefit the use of CyberKnife SBRT boost.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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Preliminary results of CyberKnife stereotactic radiotherapy (SBRT) boost for primary head and neck cancers: is it the future direction?
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