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. 2022 Nov;44(11):2571-2578.
doi: 10.1002/hed.27176. Epub 2022 Sep 1.

Intensity-modulated radiotherapy with planned Gamma Knife radiosurgery boost for head and neck cancer with extensive disease in proximity to critical structures

Joshua C Farris  1 , Cole R Steber  1 , Paul J Black  1 , Michael D Chan  1 , James D Ververs  1 , Christina K Cramer  1 , James D Browne  2 , Joshua D Waltonen  2 , Christopher A Sullivan  2 , Hafiz S Patwa  2 , Adrian W Laxton  3 , Stephen B Tatter  3 , Bart A Frizzell  1 , Mercedes Porosnicu  1   4 , Thomas W Lycan  1   4 , Kathryn M Greven  1 , Ryan T Hughes  1
Affiliations

Intensity-modulated radiotherapy with planned Gamma Knife radiosurgery boost for head and neck cancer with extensive disease in proximity to critical structures

Joshua C Farris et al. Head Neck. 2022 Nov.

Abstract

Background: To describe intensity-modulated radiotherapy (IMRT) with Gamma Knife Radiosurgery (GKRS) boost for locally advanced head and neck cancer (HNC) with disease near dose-limiting structures.

Methods: Patients with HNC treated with IMRT/GKRS as part of a combined modality approach between 2011 and 2021 were reviewed. Local control, overall survival and disease-specific survival were estimated using the Kaplan Meier method.

Results: Twenty patients were included. Nineteen patients had T3-4 tumors. Median follow-up was 26.3 months. GKRS site control was 95%. Two patients progressed at the treated primary site, one patient failed at the edge of the GKRS treatment volume, with no perineural or intracranial failure. 2-year OS was 94.7% (95% CI: 85.2%-100%). Concurrent chemotherapy was given in nine patients (45%). One patient (5%) received induction/concurrent chemotherapy. Brain radionecrosis occurred in three patients, one of which was biopsy-proven.

Conclusions: IMRT plus GKRS boost results in excellent disease control near critical structures with minimal toxicity.

Keywords: Gamma Knife; Gamma Knife boost; head and neck cancer; intensity-modulated radiation therapy; normal tissue toxicity.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Local control at the GKRS site after IMRT plus GKRS boost
FIGURE 2
FIGURE 2
Kaplan–Meier plot of recurrence free survival after IMRT plus GKRS boost
FIGURE 3
FIGURE 3
Kaplan–Meier plot of overall survival after IMRT plus GKRS boost
See this image and copyright information in PMC

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