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Stereotactic radiosurgery for locally recurrent nasopharyngeal carcinoma
Ping-Ching Pai1, Chi-Cheng Chuang, Kuo-Chen Wei
1Department of Radiation Oncology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kwei-Shan Hsiang, Taoyuan, Taiwan, R.O.C.
Background:
Stereotactic radiosurgery has been used to treat intracranial tumors. Recently, it has also been used for the treatment of head and neck tumors involving the base of skull, including recurrent NPC.
Methods:
From October 1994 to April 1999, 36 patients with recurrent NPC, were retreated by stereotactic radiosurgery. These patients received radiosurgery as a boost treatment after reirradiation for recurrence. The external RT dose ranged from 20 to 60 Gy. The tumor volume ranged from 3.58 to 24.6 cc. The target surface dose ranged from 8 to 20 Gy. The median follow-up was 22.1 months.
Results:
The 3-year local control rate was 56%. The 5-year overall survival was 49%. Persistence after radiosurgery had a worse survival than those who had secondary recurrence. Age and gender were marginally significant. No patient had new severe complications after retreatment. Four patients (11%) had nasopharyngeal necrosis after radiosurgery, none had nasal bleeding or headache, but a foul odor was present in one patient.
Conclusions:
Conformal radiotherapy and stereotactic radiotherapy provide good local control and survival without severe complications for patients with recurrent NPC.