International Journal of Head and Neck Surgery

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VOLUME 12 , ISSUE 2 ( April-June, 2021 ) > List of Articles

Original Article

Preliminary Analysis of CyberKnife Stereotactic Radiotherapy for Primary and Recurrent Head and Neck Cancers: A Delicate Balance

Trinanjan Basu, Tejinder Kataria, Shikha Goyal, Deepak Gupta

Citation Information : Basu T, Kataria T, Goyal S, Gupta D. Preliminary Analysis of CyberKnife Stereotactic Radiotherapy for Primary and Recurrent Head and Neck Cancers: A Delicate Balance. Int J Head Neck Surg 2021; 12 (2):43-47.

DOI: 10.5005/jp-journals-10001-1425

License: CC BY-NC 4.0

Published Online: 01-06-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Introduction: This is a preliminary analysis of CyberKnife (CK) stereotactic body radiotherapy (SBRT) among the Indian head and neck cancer (HNC) population. Forty-one patients (27 recurrent and 14 primary) were selected and grouped into group I (re-irradiation = 26) and group II [recurrent RT naïve or CK boost after volumetric modulated arc therapy (VMAT)/intensity-modulated radiotherapy (IMRT) = 15]. Histological types included squamous cell carcinoma (38) and adenoid cystic carcinoma (3). Materials and methods: Univariate and multivariate analyses for disease-free survival (DFS) and overall survival (OS) were performed using disease group, median tumor volume, median tumor size, positron emission tomography (PET)-CT median SUVmax, and post-CK response category. Kaplan–Meier survival and Cox proportional ratios were used using SPSS version 19.0. Results: After a median follow-up of 25 months (range: 0–39 months), all patients combined the 2 years OS and DFS were 92 and 45%, respectively. The median OS and DFS were 25 and 10 months among the cohort. Group I had II years OS and DFS of 85 and 25%, respectively, whereas group II had 2 years OS and DFS 98 and 45%, respectively. Till the last follow-up, 33 patients were alive and 5 were lost to follow-up. Eight patients in group I and only one patient in group II had disease progression. Eleven patients in group I and 12 patients in group II had partial to complete response. The median tumor volume was 29.8 cm3 and was found to be a strong statistically significant factor for DFS in univariate (p = 0.007) analysis. Treatment was well tolerated with only three-grade IV toxicities. Conclusion: CyberKnife SBRT is an attractive option for both recurrent and primary HNC. A delicate balance needs to be maintained between disease control and major adverse events.

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