title: Salvage stereotactic re-irradiation with CyberKnife for locally recurrent head and neck cancer: a single center experience.
abstract: OBJECTIVE
  We report the toxicity and preliminary clinical outcome in patients affected by locally recurrent head and neck cancer treated with stereotactic re-irradiation.
  
  
  METHODS
  Between February 2012 and August 2013, 17 patients were treated with CyberKnife as stereotactic re-irradiation for locally recurrent head and neck cancer. All patients had previously received a full dose radiation treatment with radical intent, with a median total dose of 66 Gy (range, 50-70) delivered with standard fractionation. The median interval between the primary radiotherapy and re-irradiation was 24 months (range, 10-168).
  
  
  RESULTS
  All patients completed the prescribed treatment, which was delivered in 5 fractions. The median tumor dose administered was 30 Gy (range, 25-35) prescribed to the 80% isodose line. Treatment sites were as follows: neck lymph nodes in 5 patients, paranasal sinuses in 5, oropharynx in 2, nasopharynx, and larynx, oral cavity, nasal fossa and parotid gland each in 1 patient. The median target volume treated was 58.7 cm3 (range, 8.5-211.3). Sixteen patients (94%) were evaluated for response. At a median follow-up of 7.5 months (range, 2-17), 4 patients achieved complete response (25%), 5 had partial response (31%) and 7 showed stable disease (44%). No patient showed in-field progression after re-irradiation. Grade 3 acute toxicity was noted in one patient only; no late side effect was observed during the follow-up.
  
  
  CONCLUSIONS
  Stereotactic re-irradiation with CyberKnife is an appealing non-surgical salvage treatment for selected patients with local-regionally recurrent head and neck cancer.
authors: Pierluigi
authors: P
authors: Bonomo
authors: Samantha
authors: S
authors: Cipressi
authors: Carmine
authors: C
authors: Iermano
authors: Ivano
authors: I
authors: Bonucci
authors: Laura
authors: L
authors: Masi
authors: Raffaela
authors: R
authors: Doro
authors: Virginia
authors: V
authors: Favuzza
authors: Fabiola
authors: F
authors: Paiar
authors: Gabriele
authors: G
authors: Simontacchi
authors: Icro
authors: I
authors: Meattini
authors: Daniela
authors: D
authors: Greto
authors: Benedetta
authors: B
authors: Agresti
authors: Lorenzo
authors: L
authors: Livi
authors: Giampaolo
authors: G
authors: Biti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery; D016634:Radiosurgery; D011880:Radiotherapy Planning, Computer-Assisted; D012074:Remission Induction; D019233:Retreatment; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome