title: Fractionated stereotactically guided radiotherapy of head and neck tumors: a report on clinical use of a new system in 195 cases.
abstract: Between November 1988 and December 1992, 195 patients with tumors of the head and neck (low grade gliomas, meningiomas, neurinomas, chordomas and miscellaneous) were treated with a newly developed stereotactical system for fractionated, conformal, high-precision radiotherapy. The overall preparation time, including head mask production for fixation, CT, MRI, 3-D treatment planning and stereotactical localisation could be reduced to 4-5 h per patient. The use of MR in the target definition was increased to a mean of about 60%. The medial follow-up time is 22 months. Three different patient groups were selected according to pretreatment. Patients with full high-precision radiotherapy survived in 95% of cases, patients with boost treatment in 86% and patients with preirradiated recurrent disease in 64%. Meningiomas as the largest histology group (n = 62) showed partial response in 27% and complete response in 10% of cases. Progression occurred in two patients. All patients are alive. Acute side-effects were minimal and of the order of 10%, no late complications occurred despite tumor doses ranging up to 72 Gy. High-precision radiotherapy as it is performed in Heidelberg can be regarded as an effective, reliable and tolerable system for selected tumors of the head and neck.
authors.affiliation: Radiotherapy Department, University of Heidelberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Gademann
authors.forename: W
authors.initials: W
authors.lastname: Schlegel
authors.forename: J
authors.initials: J
authors.lastname: Debus
authors.forename: L
authors.initials: L
authors.lastname: Schad
authors.forename: T
authors.initials: T
authors.lastname: Bortfeld
authors.forename: K H
authors.initials: KH
authors.lastname: Höver
authors.forename: W J
authors.initials: WJ
authors.lastname: Lorenz
authors.forename: M
authors.initials: M
authors.lastname: Wannenmacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002817:Chordoma / Q000532:radiotherapy; D005260:Female; D005910:Glioma / Q000532:radiotherapy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D008297:Male; D008579:Meningioma / Q000532:radiotherapy; D008875:Middle Aged; D009442:Neurilemmoma / Q000532:radiotherapy; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D013238:Stereotaxic Techniques