3097 Salvage Stereotactic Body Radiotherapy For

3097
Salvage Stereotactic Body Radiotherapy For Locally Recurrent Head And Neck Carcinomas
M. Cengiz, G. Ozyigit, E. Karakaya, A. Dogan, H. Beyaz, F. Yıldız, F. Akyol, M. Gurkaynak, F. Zorlu
Hacettepe University School of Med, Ankara 06100, Turkey
Purpose/Objective(s): The purpose of this study is to determine the efficacy and toxicity of stereotactic body
radiotherapy (SBRT) as a salvage treatment in patients with locally persistent and recurrent head and neck
carcinomas (HNC).
Materials/Methods: Between July 2007 and November 2008, 35 patients with locally recurrent HNC were treated
by SBRT. The sites of disease distrubition were as follows: nasopharingeal cancer, 16; paranasal sinus cancer, 7;
oral cavity cancer, 3; hypopharyngeal cancer, 4; laryngeal cancer, 1; thyroid cancer, 1; tracheal cancer,1; lacrimal
gland cancer, 1; and parotid cancer; 1. All patients had previously received full dose radical external beam
radiotherapy. Median first line radiotherapy dose was 65,5 Gy (range, 30 Gy-77,4 Gy. Time from the previous
radiotherapy to SBRT was median 66 months (range, 7-300 months). Ten patients were treated for two or more
recurrences and five of these had taken second re-iradiation before SBRT. Median SBRT dose was 30 Gy (18-35 Gy)
in median 5 fractions (1-5 fractions) in median 5 days (1-8 days) to typically 75-85% prescription isodoses. Median
follow up time was 8 months (range, 4-18 months).
Results: Seven patients had complete regression of tumor after SBRT, eleven had partial response, ten had stable
disease, and six had progression of tumor. The overall response rate was 51.4% (n=18). SBRT established ultimate
disease control in 80 % (n=28) of the patients. Disease progression in six patients occurred in median 6 months
(range, 2-9 months) after SBRT. One year survival is 66.7%. Thirteen patients (%37) were complained of grade II-III
toxicities; mucositis, dysphagia, feeding tube, fistula, myelitis and soft tissue necrosis. Moreover, three of four
patients who have presented with profuse bleeding as life threatening toxicity after 2-3 months of SBRT were died.
Conclusions: Our early result is encouraging that SBRT is an effective treatment modality with relatively good
disease control for recurrent head and neck cancer. Major treatment related mortality is bleeding. Longer follow
up with increased number of patients is essential to determine the definitive role of SBRT in this group of patients.
Author Disclosure: M. Cengiz, None; G. Ozyigit, None; E. Karakaya, None; A. Dogan, None; H. Beyaz, None; F. Yıldız,
None; F. Akyol, None; M. Gurkaynak, None; F. Zorlu, Honoraria, D. Speakers Bureau/Honoraria.