Cyberknife boost 5–10 Gy for advanced nasopharyngeal cancer

Czech version

Authors: Z. Čermáková ^1,2; J. Cvek ¹; L. Knýbl ¹; E. Skácelíková ¹; T. Paračková ^1,3
Authors‘ workplace: Klinika onkologická LF OU a FN Ostrava ¹; Ústav epidemiologie a ochrany veřejného zdraví, LF OU, Ostrava ²; Onkologická klinika LF UP v Olomouci ³
Published in: Klin Onkol 2020; 33(Suppl 1): 60-64
Category: Original Articles
doi: https://doi.org/10.14735/amko2020S60

Overview

Background: Nasopharyngeal tumors are a rare disease in our latitudes. Due to anatomical conditions and poor operability, radical radiotherapy with or without chemotherapy is used as a primary treatment modality. Due to the unsatisfactory treatment outcomes, ways to intensify the therapy and increase the curable potential under tolerable toxicity are sought.

Patients and methods: Fourteen patients with advanced nasopharyngeal non-metastatic squamous cell carcinoma, stage II–IVa, were treated at the Department of Oncology of the University Hospital Ostrava in 2010–2014. Eleven (79%) patients were treated with 70 Gy per primary tumor normalized (2 Gy) and affected lymph nodes and with 56 Gy (à 1,6 Gy) for elective lymph nodes by intensity modulated radiotherapy with integrated concomitant boost. Three (21%) patients completed radiotherapy earlier due to complications or general condition. Nine (64%) patients were exposed to concomitant chemotherapy and 6 (43%) received adjuvant chemotherapy. Fourteen (100%) patients underwent cyberboost in the primary tumor and affected lymph nodes (if any) area within a month of radical radiotherapy, five (36%) patients received 5 Gy in one fraction and nine (64%) patients received 10 Gy in 2 fractions.

Results: Out of the 14 patients, local complete remission was achieved in 10 (71%) of them after the treatment. Two (14%) patients had a post-treatment local finding as stationary, local progression with generalization occurred in one case at 18 months and in another patient at 13 months. In one patient with complete remission after the primary treatment, distant metastasis occurred in 43 months at the time of local complete remission of the disease. The average time to progression was 24.6 months. Five (64%) patients achieved 5-year survival with satisfactory toxicity of treatment.

Conclusion: Stereotactic boost after a comprehensive radiation program, with or without addition of concomitant and adjuvant chemotherapy, provides good local control and 5-year survival with satisfying toxicity of the treatment.

Keywords:

cyberknife – Nasopharyngeal carcinoma – cyber-boost – stereotactic radiation – head and neck radiation therapy

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