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Radiosurgery for recurrent cranial base cancer arising from the head and neck
Author(s) -
Firlik Katrina S.,
Kondziolka Douglas,
Lunsford L. Dade,
Janecka Ivo P.,
Flickinger John C.
Publication year - 1996
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199603/04)18:2<160::aid-hed8>3.0.co;2-#
Subject(s) - radiosurgery , medicine , head and neck cancer , radiation therapy , head and neck , radiology , surgery
Background Treatment options for head and neck cancers that recur at the cranial base are limited. Methods Twelve patients with head and neck cancers recurrent after resection and fractionated radiotherapy ( n = 11) at the cranial base had stereotactic radiosurgery using the gamma unit. The median dose to the tumor margin was 16 Gy. Imaging follow‐up varied from 3 to 17 months; the longest clinical follow‐up was at 35 months. Results Three of 8 tumors studied by postradiosurgery imaging remained unchanged in size, 3 decreased, and 2 were no longer visible. There was no morbidity or worsening of symptoms after radiosurgery. Four patients died between 4 and 8 months and did not have postradiosurgery imaging performed. Mean survival after radiosurgery was 10.5 months, with 7 patients (58%) still living. Conclusions Radiosurgery proved safe and effective in providing local control for recurrent cranial base cancers arising from the extracranial head and neck. Radiosurgery should be considered for those patients who have failed prior fractionated radiation or surgical resection, those who have tumors in high‐risk cranial locations, or those who are poor medical candidates. Although this study shows its potential adjuvant role, longer follow‐up and increased clinical experience will be necessary to evaluate the overall role of radiosurgery in head and neck cancer. HEAD & NECK 1996;18:160–166 © 1996 John Wiley & Sons, Inc.