Effect of intratumoral abscess/necrosis on the outcome for head and neck cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife®.

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Effect of intratumoral abscess/necrosis on the outcome for head and neck cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife®.

Mol Clin Oncol. 2017 Sep;7(3):336-340

Authors: Yamazaki H, Ogita M, Himei K, Nakamura S, Suzuki G, Kotsuma T, Yoshida K, Yoshioka Y

Abstract
The aim of the present study was to elucidate the effect of intratumoral abscess/necrosis (AN) on the outcome of patients with recurrent head and neck cancer (HNC) treated by stereotactic radiotherapy. The records of 67 patients treated with CyberKnife® in four institutes between August 2000 and July 2010 were reviewed. The frequency of AN appeared to be increased in younger postoperative patients with large ulcerative tumors. The AN(+) group exhibited a better initial response rate compared with the AN(-) group (64 vs. 33%, respectively; P=0.04). The 1-year local control rate was 51 and 75% in the AN(+) and AN(-) groups, respectively (P=0.01), while the respective 1-year overall survival rates were 53 and and 71% (P=0.0004). A total of 21 patients (31%) experienced grade ≥3 toxicities, and carotid blowout syndrome (CBOS) was found in 11 patients, resulting in 8 deaths. A significantly larger proportion of patients in the AN(+) group developed CBOS (8/18; 44%) compared with the AN(-) group (3/49; 6%) (P=0.001). Therefore, AN may be an important prognostic factor for patients with recurrent HNC, as well as a predictor of lethal toxicity due to CBOS.

PMID: 28781810 [PubMed]

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