Image-guided radiosurgery of head and neck cancers.
OBJECTIVE
Radiosurgery precisely delivers a single high dose or a few fractionated doses of radiation to a localized tumor via the stereotactic approach. Some head and neck sites are suitable for radiosurgery since there is minimal or no organ motion. The clinical studies were carried out to determine the accuracy of stereotactic radiosurgery and to demonstrate the effectiveness of radiosurgery in head and neck cancers.


METHODS
Thirteen patients were treated with either single-dose or fractionated radiosurgery to the tumor. All patients except one with cancer of the lip had received prior treatments including surgery, radiotherapy, and chemotherapy for the primary cancers. The dose ranged 12 to 18 Gy for single-dose radiosurgery and 30 Gy in 5 or 6 fractions twice a week for fractionated radiosurgery. Tumor localization was achieved via the stereotactic approach.


RESULTS
Accuracy of radiosurgery was within 1.5 mm. Despite the recurrent disease from previous heavy treatments, 9 patients (70%) showed a significant response (complete or >50% tumor reduction) to radiosurgery, and 3 patients had stable disease. Complete tumor response was achieved in 6 patients. All patients had excellent pain relief with functional and cosmetic preservation. There was no acute and subacute radiation toxicity detected clinically during the minimal follow-up of 6 months.


CONCLUSIONS
Image-guided radiosurgery is effective in achieving the local tumor control and pain relief. Radiosurgery provided excellent functional and cosmetic preservation with minimal complication. The results indicate the potential of radiosurgery in the treatment of recurrent and selected primary head and neck cancers.
Ryu
Samuel
S
Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI 48202, USA. sryu1@hfhs.org
Khan
Mumtaz
M
Yin
Fang-Fang
FF
Concus
Adrianne
A
Ajlouni
Munther
M
Benninger
Michael S
MS
Kim
Jae Ho
JH
D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D016634:Radiosurgery / Q000295:instrumentation*; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*