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

Megan E Daly, Allen M. Chen, M. Kara Bucci, Ivan El-Sayed, Ping Xia, Michael J. Kaplan, David W. Eisele

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)151-157
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume67
Issue number1
DOIs
StatePublished - Jan 1 2007

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paranasal sinuses
sinuses
Paranasal Sinuses
Nasal Cavity
radiation therapy
Radiotherapy
cavities
Neoplasms
Tumor Burden
chiasms
tumors
incidence
Xerophthalmia
Olfactory Esthesioneuroblastoma
optics
Ethmoid Sinus
cataracts
Optic Chiasm
Adenoids
histology

Keywords

  • Cancer
  • Intensity-modulated radiation therapy
  • Nasal cavity
  • Paranasal sinus

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Intensity-modulated radiation therapy for malignancies of the nasal cavity and paranasal sinuses. / Daly, Megan E; Chen, Allen M.; Bucci, M. Kara; El-Sayed, Ivan; Xia, Ping; Kaplan, Michael J.; Eisele, David W.

In: International Journal of Radiation Oncology Biology Physics, Vol. 67, No. 1, 01.01.2007, p. 151-157.

Research output: Contribution to journalArticle

Daly, Megan E ; Chen, Allen M. ; Bucci, M. Kara ; El-Sayed, Ivan ; Xia, Ping ; Kaplan, Michael J. ; Eisele, David W. / Intensity-modulated radiation therapy for malignancies of the nasal cavity and paranasal sinuses. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 67, No. 1. pp. 151-157.
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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.",
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