Clinical Experience with a CyberKnife in the Treatment of Head and Neck Tumors

Abstract

The CyberKnife is an image-guided frameless dedicated stereotactic radiotherapeutic device. This instrument is composed of a combination of a robot manipulator and LINIAC. Between January 2004 and August 2007, 11 patients with 15 malignant lesions of the head and neck were treated with this system because of tumor recurrence, difficulty in surgery or additional increase after external radiotherapy. Primary lesions were diagnosed in 8 cases. Of 8 these cases, 5 cases involved the paranasal sinus, 2 cases involved the temporal bone, and 1 case involved the parapharyngeal space. Metastatic lymph nodes were found in two cases and metastatic bone observed in one case. The response rate (CR+PR) was 13.3% and local control rate (CR+PR+SD) was 80.0%. Adverse events were assessed by the Common Terminology Criteria for Adverse Events (CTCAE) v. 3 (10/2004). Grade 3 was observed in three cases and grade 4 in one case. Our early experience indicates that CyberKnife is an effective treatment for local control of locally advanced or recurrent head and neck tumor, however adverse events are not rare.