Journal of Hong Kong College of Radiologists

Volume 4 Number 1, 2001

The Impact of Stereotactic Radiotherapy on Nasopharyngeal Carcinoma Management

S Y Tsao
Department of Radiation Therapy, Gleneagles Cancer Centre Singapore, Singapore

Stereotactic radiation therapy (SRT) is not a new technique. Its history dates back to at least the 50s but the technique was not adopted then for routine use because it was not practicable. With the advent of modern cross-sectional imaging, fast but affordable computers and efficient treatment planning software, the potential for SRT as a routine treatment delivery method for nasopharyngeal carcinoma (NPC) is getting greater and greater. Our Centre has found SRT a highly acceptable and effective method for local relapse of NPC. For new patients, it is hoped SRT will help decrease the frequency of the radiation sequelae that are so prevalent in surviving patients. The higher initial cost of SRT can easily be offset by the savings on management of long-term radiation sequelae. The quality of life of surviving patients is enhanced, moreover the loss of life through life-threatening sequelae, for example, temporal lobe necrosis is reduced. However, the extra costs of micro-multi-leaf Collimator (mMLC) have to be justified by the saving of manpower and machine time. In small to medium sized centres with optimum case loads, this may not be justified. With the availability of the pencil beam algorithm, the accuracy of treatment delivery is further enhanced. Hopefully, most centres managing NPC will be able to adopt SRT as part of their routine management programme for NPC. (J HK Coll Radiol 2001;1:44-52)

Key words : Stereotactic radiotherpay, Nasopharyngeal neoplasm, Relapse salvage, Complications of radiotherapy, Dose fractionation

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