Nasopharyngeal cancer
Gamma knife is traditionally used for brain tumour or brain cancers. Have you heard gamma knife used for nasopharyngeal cancer?
Mr. G was diagnosed stage 3 Nasopharyngeal cancer in 2012. He had the usual treatment regimen consisting of chemotherapy and concurrent chemoradiotherapy and he was in remission till 2023. He has some left-over side effects from his previous radiation such as dry mouth and neck stiffness.
He went for his 6 monthly nasal endoscopy and found a suspicious lesion in his nasopharynx. A CT scan was ordered and revealed a small localized mass in the right nasopharynx. A PET scan showed no distant spread.
His treatment options were either a nasopharyngectomy or re irradiation. He choose the later as its noninvasive. Traditionally re irradiation can be done with IMRT/VMAT or brachytherapy. Brachytherapy is obsolete as its hard to get the dose conformed to the tumour.
Since we have gamma knife and we know gamma knife can conform the dose very closely to the tumour and spare normal tissues. We started searching for literature and evidence for a suitable fractionation for Mr. G and found 35Gys in 5# to be the best.
An IMRT/VMAT fractionation would be 35 fraction and with Gamma knife, we can complete the treatment in 5 fractions. It’s cheaper, safer and less time consuming. He successfully completed his Gamma knife treatment for a recurrent nasopharyngeal cancer (NPC) and I can't wait to see his scans in the next 3 months.
Nasopharyngeal cancer
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