Stereotactic Radiosurgery in Treating Patients With Locally Advanced or Recurrent Head and Neck Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Biopsy-confirmed\* invasive head and neck cancer, including the following primary sites:
• •* Nasopharynx
• •* Oropharynx
• •* Paranasal sinus
• •* Oral cavity
• •* Orbit
• •* Salivary gland NOTE: \*Biopsy must be performed prior to initiation of external beam radiotherapy (EBRT)
• •Stage T2-4 tumor at the time of diagnosis
• •* Primary tumor ≤ 5 cm in diameter at the time of CyberKnife® stereotactic radiosurgery (SRS)
• •Meets one of the following criteria:
• •* Eligible for CyberKnife® SRS as boost therapy, as defined by one of the following criteria:
• •* Planning to undergo definitive EBRT, with or without chemotherapy, with curative intent for primary head and neck cancer
• •* Biopsy-confirmed locally persistent disease \< 3 months after completion of definitive EBRT
• •* Eligible for CyberKnife® SRS as salvage therapy\*, as defined by one of the following criteria:
• •* Biopsy-confirmed locally recurrent disease occurring ≥ 6 months after the completion of radiotherapy; achieved a complete response to initial therapy by imaging or clinical examination; had \> 50% of the tumor volume in the prior irradiated volume; and received \> 45 Gy of radiotherapy
• •* Biopsy-confirmed locally recurrent disease occurring between 6 weeks and 6 months after the completion of radiotherapy; achieved a complete response to initial therapy by imaging or clinical examination; had \< 50% of the tumor volume in the prior irradiated volume; and received \> 45 Gy of radiotherapy NOTE: \*Not a candidate for salvage surgery or brachytherapy
• •Anticipated total dose of radiotherapy to the spinal cord ≤ 50 Gy (including prior dose)
• •PATIENT CHARACTERISTICS:
• •Karnofsky performance status 60-100%
• •Not pregnant or nursing
• •Fertile patients must use effective contraception
• •Able to achieve normal tissue tolerance to critical structures with the CyberKnife® planning system
• •Able to undergo CT simulation
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics