Intensity-modulated radiotherapy for tumors of the nasal cavity and paranasal sinuses: Clinical outcomes and patterns of failure

Ellen A. Wiegner, Megan E Daly, James D. Murphy, Jonathan Abelson, Chris H. Chapman, Melody Chung, Yao Yu, A. Dimitrios Colevas, Michael J. Kaplan, Nancy Fischbein, Quynh Thu Le, Daniel T. Chang

Research output: Contribution to journalArticle

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Abstract

Purpose: To report outcomes in patients treated with intensity-modulated radiotherapy (IMRT) for tumors of the paranasal sinuses and nasal cavity (PNS/NC). Methods/Materials: Between June 2000 and December 2009, 52 patients with tumors of the PNS/NC underwent postoperative or definitive radiation with IMRT. Twenty-eight (54%) patients had squamous cell carcinoma (SCC). Twenty-nine patients (56%) received chemotherapy. The median follow-up was 26.6 months (range, 2.9-118.4) for all patients and 30.9 months for living patients. Results: Eighteen patients (35%) developed local-regional failure (LRF) at median time of 7.2 months. Thirteen local failures (25%) were observed, 12 in-field and 1 marginal. Six regional failures were observed, two in-field and four out-of-field. No patients treated with elective nodal radiation had nodal regional failure. Two-year local-regional control (LRC), in-field LRC, freedom from distant metastasis (FFDM), and overall survival (OS) were 64%, 74%, 71%, and 66% among all patients, respectively, and 43%, 61%, 61%, and 53% among patients with SCC, respectively. On multivariate analysis, SCC and >1 subsite involved had worse LRC (p = 0.0004 and p = 0.046, respectively) and OS (p = 0.003 and p = 0.046, respectively). Cribriform plate invasion (p = 0.005) and residual disease (p = 0.047) also had worse LRC. Acute toxicities included Grade ≥3 mucositis in 19 patients (37%), and Grade 3 dermatitis in 8 patients (15%). Six patients had Grade ≥3 late toxicity including one optic toxicity. Conclusions: IMRT for patients with PNS/NC tumors has good outcomes compared with historical series and is well tolerated. Patients with SCC have worse LRC and OS. LRF is the predominant pattern of failure.

Original languageEnglish (US)
Pages (from-to)243-251
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume83
Issue number1
DOIs
StatePublished - May 1 2012
Externally publishedYes

Fingerprint

paranasal sinuses
sinuses
Intensity-Modulated Radiotherapy
Paranasal Sinuses
Nasal Cavity
radiation therapy
tumors
cavities
Neoplasms
Squamous Cell Carcinoma
cancer
toxicity
grade
Survival
dermatitis
Ethmoid Bone
Radiation
Mucositis

Keywords

  • IMRT
  • Nasal cavity
  • Outcomes
  • Paranasal sinus
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Intensity-modulated radiotherapy for tumors of the nasal cavity and paranasal sinuses : Clinical outcomes and patterns of failure. / Wiegner, Ellen A.; Daly, Megan E; Murphy, James D.; Abelson, Jonathan; Chapman, Chris H.; Chung, Melody; Yu, Yao; Colevas, A. Dimitrios; Kaplan, Michael J.; Fischbein, Nancy; Le, Quynh Thu; Chang, Daniel T.

In: International Journal of Radiation Oncology Biology Physics, Vol. 83, No. 1, 01.05.2012, p. 243-251.

Research output: Contribution to journalArticle

Wiegner, EA, Daly, ME, Murphy, JD, Abelson, J, Chapman, CH, Chung, M, Yu, Y, Colevas, AD, Kaplan, MJ, Fischbein, N, Le, QT & Chang, DT 2012, 'Intensity-modulated radiotherapy for tumors of the nasal cavity and paranasal sinuses: Clinical outcomes and patterns of failure', International Journal of Radiation Oncology Biology Physics, vol. 83, no. 1, pp. 243-251. https://doi.org/10.1016/j.ijrobp.2011.05.044
Wiegner, Ellen A. ; Daly, Megan E ; Murphy, James D. ; Abelson, Jonathan ; Chapman, Chris H. ; Chung, Melody ; Yu, Yao ; Colevas, A. Dimitrios ; Kaplan, Michael J. ; Fischbein, Nancy ; Le, Quynh Thu ; Chang, Daniel T. / Intensity-modulated radiotherapy for tumors of the nasal cavity and paranasal sinuses : Clinical outcomes and patterns of failure. In: International Journal of Radiation Oncology Biology Physics. 2012 ; Vol. 83, No. 1. pp. 243-251.
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abstract = "Purpose: To report outcomes in patients treated with intensity-modulated radiotherapy (IMRT) for tumors of the paranasal sinuses and nasal cavity (PNS/NC). Methods/Materials: Between June 2000 and December 2009, 52 patients with tumors of the PNS/NC underwent postoperative or definitive radiation with IMRT. Twenty-eight (54{\%}) patients had squamous cell carcinoma (SCC). Twenty-nine patients (56{\%}) received chemotherapy. The median follow-up was 26.6 months (range, 2.9-118.4) for all patients and 30.9 months for living patients. Results: Eighteen patients (35{\%}) developed local-regional failure (LRF) at median time of 7.2 months. Thirteen local failures (25{\%}) were observed, 12 in-field and 1 marginal. Six regional failures were observed, two in-field and four out-of-field. No patients treated with elective nodal radiation had nodal regional failure. Two-year local-regional control (LRC), in-field LRC, freedom from distant metastasis (FFDM), and overall survival (OS) were 64{\%}, 74{\%}, 71{\%}, and 66{\%} among all patients, respectively, and 43{\%}, 61{\%}, 61{\%}, and 53{\%} among patients with SCC, respectively. On multivariate analysis, SCC and >1 subsite involved had worse LRC (p = 0.0004 and p = 0.046, respectively) and OS (p = 0.003 and p = 0.046, respectively). Cribriform plate invasion (p = 0.005) and residual disease (p = 0.047) also had worse LRC. Acute toxicities included Grade ≥3 mucositis in 19 patients (37{\%}), and Grade 3 dermatitis in 8 patients (15{\%}). Six patients had Grade ≥3 late toxicity including one optic toxicity. Conclusions: IMRT for patients with PNS/NC tumors has good outcomes compared with historical series and is well tolerated. Patients with SCC have worse LRC and OS. LRF is the predominant pattern of failure.",
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AU - Murphy, James D.

AU - Abelson, Jonathan

AU - Chapman, Chris H.

AU - Chung, Melody

AU - Yu, Yao

AU - Colevas, A. Dimitrios

AU - Kaplan, Michael J.

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N2 - Purpose: To report outcomes in patients treated with intensity-modulated radiotherapy (IMRT) for tumors of the paranasal sinuses and nasal cavity (PNS/NC). Methods/Materials: Between June 2000 and December 2009, 52 patients with tumors of the PNS/NC underwent postoperative or definitive radiation with IMRT. Twenty-eight (54%) patients had squamous cell carcinoma (SCC). Twenty-nine patients (56%) received chemotherapy. The median follow-up was 26.6 months (range, 2.9-118.4) for all patients and 30.9 months for living patients. Results: Eighteen patients (35%) developed local-regional failure (LRF) at median time of 7.2 months. Thirteen local failures (25%) were observed, 12 in-field and 1 marginal. Six regional failures were observed, two in-field and four out-of-field. No patients treated with elective nodal radiation had nodal regional failure. Two-year local-regional control (LRC), in-field LRC, freedom from distant metastasis (FFDM), and overall survival (OS) were 64%, 74%, 71%, and 66% among all patients, respectively, and 43%, 61%, 61%, and 53% among patients with SCC, respectively. On multivariate analysis, SCC and >1 subsite involved had worse LRC (p = 0.0004 and p = 0.046, respectively) and OS (p = 0.003 and p = 0.046, respectively). Cribriform plate invasion (p = 0.005) and residual disease (p = 0.047) also had worse LRC. Acute toxicities included Grade ≥3 mucositis in 19 patients (37%), and Grade 3 dermatitis in 8 patients (15%). Six patients had Grade ≥3 late toxicity including one optic toxicity. Conclusions: IMRT for patients with PNS/NC tumors has good outcomes compared with historical series and is well tolerated. Patients with SCC have worse LRC and OS. LRF is the predominant pattern of failure.

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