Abstract
Cyberknife radiosurgery is a frameless stereotactic robotic radiosurgery which has
shown to deliver better treatment outcomes in the treatment of advanced head and neck
(H&N) carcinomas, especially in previously irradiated and recurrent cases. The aim
of the study was to perform a systematic review of the available data on the outcomes
of Cyberknife radiosurgery for treatment of head and neck cancer and to evaluate its
collective outcomes. This systematic review was registered with the university with
the registration no. FRP/2019/63 and was approved by the Institutional Review Board
(RC/IRB/2019/132). Literature search was performed in the following: PubMed, Science
direct, SciELO, MyScienceWork, Microsoft Academ EMBASE, Directory of Open Access Journals,
and Cochrane databases with the keywords “Cyberknife,” “oral cancer,” “oropharyngeal
cancer,” and “head and neck cancer” and data was extracted according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The
records identified were 147 manuscripts. Excluded articles included 5 duplicate articles,
33 abstracts, 101 full text articles due to being off-topic, case reports, review,
non-English, 1 survey, and 2 other articles containing data extracted from a main
study which was already included. A total of 5 articles were evaluated for qualitative
synthesis. The mean dose of Cyberknife radiosurgery delivered for previously irradiated
recurrent H&N carcinoma patients was 34.57 Gy, with a mean sample size of 5 studied
during the period of 2000 to 2016. The available evidence from the systematic review
indicates that Cyberknife can be an efficacious treatment option for recurrent previously
irradiated H&N carcinoma, especially for nonresectable tumors. There is paucity of
homogenous data and studies in this arena; hence, meta-analysis could not be performed.
Further standardized studies are essential, especially where the treatment of H&N
carcinoma is considered.
Keywords
cyberknife radiosurgery - oropharyngeal neoplasms - treatment outcomes of cyberknife
- cyberknife radiotherapy - head and neck neoplasm - targeted radiation therapy -
stereotactic radiotherapy - robotic radiosurgery
