title: Salvage stereotactic reirradiation using the CyberKnife for the local recurrence of nasal or paranasal carcinoma.
abstract: OBJECTIVE
  To evaluate the clinical outcome of stereotactic reirradiation using the CyberKnife system for recurrent nasal or paranasal carcinoma.
  
  
  METHODS
  From May 2005 to February 2010, 51 patients with local recurrence of nasal or paranasal carcinoma were reirradiated using CyberKnife. Tumor volume ranged from 3.1 to 204.9 ml (median, 33.8). The previous conventional radiotherapy dose ranged from 40 to 70 Gy (median, 60). The median follow-up period for surviving patients was 21 months (range, 12-52). The marginal doses were 20-41.5 Gy in 1-5 fractions (35 Gy). Toxicities were evaluated with the Common Terminology Criteria for Adverse Events version 4.0.
  
  
  RESULTS
  The median overall survival and local control periods after reirradiation were 14.5 and 9.5 months, respectively. The 1-year survival and local control rates were 67% and 62%, respectively. Grade 3 or higher adverse events were observed in 23%. Grade 4 dermatitis and soft tissue necrosis were observed in 2 and 1 patients who had received trimodality combination therapy as their previous treatment, respectively.
  
  
  CONCLUSIONS
  Salvage stereotactic reirradiation using CyberKnife is feasible and effective for the local recurrence of nasal and paranasal carcinomas. To further improve treatment outcomes, exploration of better planning and dose fractionation, as well as combination chemotherapy would be worthwhile.
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. h-iwa-ncu@nifty.com
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Iwata
authors.forename: Koshi
authors.initials: K
authors.lastname: Tatewaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Inoue
authors.forename: Naoki
authors.initials: N
authors.lastname: Yokota
authors.forename: Kengo
authors.initials: K
authors.lastname: Sato
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D009669:Nose Neoplasms / Q000401:mortality / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016879:Salvage Therapy