Long-term follow-up of stereotactic radiosurgery for head and neck malignancies.

BACKGROUND Stereotactic radiosurgery is widely applied to deliver additional dose to head and neck tumors. However, its safety and efficacy remains equivocal. METHODS One hundred eighty-four patients with primary head and neck cancers treated between January 1990 and August 2012 with Gamma Knife stereotactic radiosurgery were retrospectively reviewed. RESULTS Two hundred fifteen sites were treated with Gamma Knife stereotactic radiosurgery among 184 patients. Fifty-one percent of patients received concurrent external beam radiotherapy (EBRT), 72% had prior surgery, and 46% received chemotherapy. Most (44%) had squamous cell carcinoma and most patients (65%) were treated for recurrent disease. With a median follow-up of 17.3 months, 12-month local control was 82%. Late effects occurred in 59 patients with the most common being temporal lobe necrosis (15 patients). CONCLUSION Radiosurgery can provide tumor control for patients with head and neck cancers involving the skull base. Long-term follow-up is important in survivors to identify late effects.