open access

Vol 17, No 5 (2012)
Special Issue Papers
Published online: 2012-09-01
Submitted: 2011-12-10
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Initial experience of hypofractionated radiation retreatment with true beam and flattening filter free beam in selected case reports of recurrent nasopharyngeal carcinoma

Filippo Alongi, Elena Clerici, Sara Pentimalli, Pietro Mancosu, Marta Scorsetti
DOI: 10.1016/j.rpor.2012.07.012
·
Rep Pract Oncol Radiother 2012;17(5):262-268.

open access

Vol 17, No 5 (2012)
Special Issue Papers
Published online: 2012-09-01
Submitted: 2011-12-10

Abstract

Aim

To show our preliminary experience in using TrueBeam with RapidArc technology and FFF beam for stereotactic re-irradiation of nasopharyngeal carcinoma.

Background

Thanks to new advanced techniques, as well as intensity modulated radiation therapy, it is possible to approach head and neck recurrences in selected patients. Volumetric Modulated Arc Therapy (VMAT) in its RapidArc® format, permits to reduce significantly the time to deliver complex intensity modulated plans, allowing to treat hypofractionated regimes within a few minutes. With TrueBeam it is possible to perform photon beams without usage of the flattening filter. It seems possible to expect a reduction of out-of-field dose when flattening filter free (FFF) beams are used. While research into the physics domain for FFF beams is increasing, there are very few clinical data where FFF beams are applied in clinical practice.

Materials and methods

We present here the cases of 4 patients with local or regional recurrence of nasopharyngeal carcinoma. All patients were treated using TrueBeam with RapidArc technology and FFF beam for stereotactic hypofractionated re-irradiation.

Results

All patients concluded SBRT and showed good tolerability. During follow-up, complete response at imaging evaluation (PET and/or MRI) for all treated patients was documented.

Conclusions

Our preliminary experience using TrueBeam with RapidArc technology and FFF beam for stereotactic hypofractionated re-irradiation of nasopharyngeal carcinoma was safe and effective in all 4 treated patients. Longer follow-up and a larger population of study is needed to confirm these promising results.

Abstract

Aim

To show our preliminary experience in using TrueBeam with RapidArc technology and FFF beam for stereotactic re-irradiation of nasopharyngeal carcinoma.

Background

Thanks to new advanced techniques, as well as intensity modulated radiation therapy, it is possible to approach head and neck recurrences in selected patients. Volumetric Modulated Arc Therapy (VMAT) in its RapidArc® format, permits to reduce significantly the time to deliver complex intensity modulated plans, allowing to treat hypofractionated regimes within a few minutes. With TrueBeam it is possible to perform photon beams without usage of the flattening filter. It seems possible to expect a reduction of out-of-field dose when flattening filter free (FFF) beams are used. While research into the physics domain for FFF beams is increasing, there are very few clinical data where FFF beams are applied in clinical practice.

Materials and methods

We present here the cases of 4 patients with local or regional recurrence of nasopharyngeal carcinoma. All patients were treated using TrueBeam with RapidArc technology and FFF beam for stereotactic hypofractionated re-irradiation.

Results

All patients concluded SBRT and showed good tolerability. During follow-up, complete response at imaging evaluation (PET and/or MRI) for all treated patients was documented.

Conclusions

Our preliminary experience using TrueBeam with RapidArc technology and FFF beam for stereotactic hypofractionated re-irradiation of nasopharyngeal carcinoma was safe and effective in all 4 treated patients. Longer follow-up and a larger population of study is needed to confirm these promising results.

Get Citation

Keywords

Reirradiation; Hypofractionation; Nasopharyngeal carcinoma; Flattening filter free beam

About this article
Title

Initial experience of hypofractionated radiation retreatment with true beam and flattening filter free beam in selected case reports of recurrent nasopharyngeal carcinoma

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 17, No 5 (2012)

Pages

262-268

Published online

2012-09-01

DOI

10.1016/j.rpor.2012.07.012

Bibliographic record

Rep Pract Oncol Radiother 2012;17(5):262-268.

Keywords

Reirradiation
Hypofractionation
Nasopharyngeal carcinoma
Flattening filter free beam

Authors

Filippo Alongi
Elena Clerici
Sara Pentimalli
Pietro Mancosu
Marta Scorsetti

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