Intensity-modulated radiation therapy for malignancies of the nasal cavity and paranasal sinuses

Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):151-7. doi: 10.1016/j.ijrobp.2006.07.1389.

Abstract

Purpose: To report the clinical outcome of patients treated with intensity-modulated radiation therapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses.

Methods and materials: Between 1998 and 2004, 36 patients with malignancies of the sinonasal region were treated with IMRT. Thirty-two patients (89%) were treated in the postoperative setting after gross total resection. Treatment plans were designed to provide a dose of 70 Gy to 95% or more of the gross tumor volume (GTV) and 60 Gy to 95% or more of the clinical tumor volume (CTV) while sparing neighboring critical structures including the optic chiasm, optic nerves, eyes, and brainstem. The primary sites were: 13 ethmoid sinus, 10 maxillary sinus, 7 nasal cavity, and 6 other. Histology was: 12 squamous cell, 7 esthesioneuroblastoma, 5 adenoid cystic, 5 undifferentiated, 5 adenocarcinoma, and 2 other. Median follow-up was 51 months among surviving patients (range, 9-82 months).

Results: The 2-year and 5-year estimates of local control were 62% and 58%, respectively. One patient developed isolated distant metastasis, and none developed isolated regional failure. The 5-year rates of disease-free and overall survival were 55% and 45%, respectively. The incidence of ocular toxicity was minimal with no patients reporting decreased vision. Late complications included xerophthalmia (1 patient), lacrimal stenosis (1 patient), and cataract (1 patient).

Conclusion: Although IMRT for malignancies of the sinonasal region does not appear to lead to significant improvements in disease control, the low incidence of complications is encouraging.

MeSH terms

  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Adenoid Cystic / radiotherapy
  • Carcinoma, Adenoid Cystic / secondary
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / secondary
  • Esthesioneuroblastoma, Olfactory / radiotherapy
  • Esthesioneuroblastoma, Olfactory / secondary
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Cavity
  • Neoplasm Staging
  • Nose Neoplasms / pathology
  • Nose Neoplasms / radiotherapy*
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / radiotherapy*
  • Radiation Injuries / etiology
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated*