ABSTRACT
Los pacientes con recidiva irresecable de un cáncer de cabeza y cuello (CCC) tienen un pronóstico desfavorable, con limitadas opciones de tratamiento. Los recientes avances técnicos permiten administrar la radioterapia (RT) con gran precisión, haciendo posible reirradiar tumores recidivados mediante radioterapia estereotáxica corporal (SBRT), administrando dosis elevadas de RT al mismo tiempo que se protegen los tejidos sanos próximos al tumor. Aunque esta técnica se ha utilizado para irradiar distintos tumores primarios y sus metástasis, la SBRT en cabeza y cuello ha tenido una evolución mucho más lenta que en otras localizaciones debido a las dificultades para reirradiar los CCC, por la toxicidad esperable al tratarse de una zona relativamente pequeña con gran vascularización e inervación, y donde se asientan varios sentidos. Presentamos el primer caso clínico de reirradiación con SBRT de una recidiva de un CCC en el Complejo Hospitalario de Navarra, que mostró respuesta completa y que permanece asintomático dieciséis meses después
Patients with an unresectable recurrence of head and neck carcinoma (HNC) have a poor prognosis, with limited treatment options. Recent technical advances allow radiotherapy (RT) to be handled with great precision, making it possible to re-irradiate recurrent tumors by means of stereotactic body radiotherapy (SBRT) with high doses of RT while protecting healthy tissues near the tumor. Although this technique has been used to irradiate different primary tumors and their metastases, SBRT in HNC has had a much slower evolution than in the mentioned locations. This is due to the difficulties in re-irradiating the HNC, because of the expected toxicity as it is a relatively small area with dense vascularization and innervation, and where several senses are located. We present the first case of a HNC re-irradiated with SBRT in the Complejo Hospitalario de Navarra; the patient showed a complete response and continues to be disease-free sixteen months after the irradiation
Subject(s)
Humans , Male , Middle Aged , Head and Neck Neoplasms/radiotherapy , Radiosurgery/methods , Re-Irradiation/methods , Neoplasm Recurrence, Local/radiotherapy , Head and Neck Neoplasms/pathology , Radiotherapy, Conformal/methods , Progression-Free Survival , Treatment OutcomeABSTRACT
Patients with an unresectable recurrence of head and neck carcinoma (HNC) have a poor prognosis, with limited treatment options. Recent technical advances allow radiotherapy (RT) to be handled with great precision, making it possible to re-irradiate recurrent tumors by means of stereotactic body radiotherapy (SBRT) with high doses of RT while protecting healthy tissues near the tumor. Although this technique has been used to irradiate different primary tumors and their metastases, SBRT in HNC has had a much slower evolution than in the mentioned locations. This is due to the difficulties in re-irradiating the HNC, because of the expected toxicity as it is a relatively small area with dense vascularization and innervation, and where several senses are located. We present the first case of a HNC re-irradiated with SBRT in the Complejo Hospitalario de Navarra; the patient showed a complete response and continues to be disease-free sixteen months after the irradiation.
