Stereotactic radiosurgery for locally recurrent nasopharyngeal carcinoma.
BACKGROUND
Stereotactic radiosurgery has been used to treat intracranial tumors. Recently, it has also been used for the treatment of head and neck tumors involving the base of skull, including recurrent NPC.


METHODS
From October 1994 to April 1999, 36 patients with recurrent NPC, were retreated by stereotactic radiosurgery. These patients received radiosurgery as a boost treatment after reirradiation for recurrence. The external RT dose ranged from 20 to 60 Gy. The tumor volume ranged from 3.58 to 24.6 cc. The target surface dose ranged from 8 to 20 Gy. The median follow-up was 22.1 months.


RESULTS
The 3-year local control rate was 56%. The 5-year overall survival was 49%. Persistence after radiosurgery had a worse survival than those who had secondary recurrence. Age and gender were marginally significant. No patient had new severe complications after retreatment. Four patients (11%) had nasopharyngeal necrosis after radiosurgery, none had nasal bleeding or headache, but a foul odor was present in one patient.


CONCLUSIONS
Conformal radiotherapy and stereotactic radiotherapy provide good local control and survival without severe complications for patients with recurrent NPC.
Department of Radiation Oncology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kwei-Shan Hsiang, Taoyuan, Taiwan, R.O.C.
Ping-Ching
PC
Pai
Chi-Cheng
CC
Chuang
Kuo-Chen
KC
Wei
Ngan-Ming
NM
Tsang
Chen-Kan
CK
Tseng
Chen-Nen
CN
Chang
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D004844:Epistaxis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D009305:Nasopharynx / Q000473:pathology; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D019291:Skull Base / Q000528:radiation effects; D015996:Survival Rate