Ariel Joseph Lederman, Presenter: Nothing to Disclose

Mordechai Loksen, Abstract Co-Author: Nothing to Disclose

Thomas Lowinger, Abstract Co-Author: Nothing to Disclose

Alexandra Khaleel, Abstract Co-Author: Nothing to Disclose

Daniel Izon, Abstract Co-Author: Nothing to Disclose

Gilbert S. Lederman MD, Abstract Co-Author: Nothing to Disclose

Purpose/Objective(s): Hypofractionated Stereotactic Body Radiosurgery (HFSR) is a non-invasive focused beam technique delivering high dose radiation to extracranial cancers. We analyzed HFSR as treatment for recurrent head and neck cancers that were re-treated in the primary site.Materials/Methods: 19 recurrent head and neck tumors were re-treated in 18 patients during a 55 month interval. All the patients were evaluated before and after treatment. Age ranged from 29 to 85 (mean 63) with 9 females and 10 males. Tumor volumes ranged from 7.8 cc to 1297.9 cc (mean 158.4 cc). Patients received 200-800 cGy (median 600 cGy) with 42% receiving 4 fractions and 58% receiving 5 fractions for a total dose of 1000-4000 cGy (median 2500 cGy). Cancers were radiographically evaluated with contrast CT and/or MRI studies and reviewed by independent radiologists. Control of the treated cancer is defined as cessation of growth, shrinkage or disappearance of the cancer after treatment.Results: Follow up ranged from 2 to 49 months (mean 12). Overall control rate was 84.2%. For tumors <158.4 cc, there was an 87.5% control rate. Control rate for tumors ≥158.4 cc, was 67%. For tumors that received a dose <2600 cGy, there was an 80% control rate compared to 100% control rate for tumors receiving a dose ≥2600 cGy. For tumors <158.4 cc that received <2600 cGy, there was an 83% control rate versus 100% control rate for tumors 2600 cGy. No tumors ≥158.4 cc received ≥2600 cGy.Conclusions: HFSR for recurrent head and neck cancers re-treated in the primary site when prior treatment did not succeed offers a usually well-tolerated, non-invasive method with a high degree of tumor control. A larger cohort may show a dose response analysis, as is suggested in this study. Patients will continue to be evaluated to provide longer follow up, possible benefits of local control and potential survival advantage. HFSR for recurrent primary head and neck cancers remains an option for those whom standard approaches have not produced desired results or in patients seeking a non-surgical, non-chemotherapeutic treatment.

Lederman, A, Loksen, M, Lowinger, T, Khaleel, A, Izon, D, Lederman, G, Recurrent Head and Neck Cancers Treated in the Primary Site with Hypofractionated Stereotactic Radiosurgery.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14041771.html