Intensity-Modulated Radiotherapy for Tumors of the Nasal Cavity and Paranasal Sinuses: Clinical Outcomes and Patterns of Failure

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

doi:10.1016/j.ijrobp.2011.05.044

Cited by 52 publications

(42 citation statements)

References 31 publications

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“…Fifteen studies published between 1983 and 2009 [3-17], describing the clinical outcome and optic toxicity in detail after 2D or 3D RT; 2 studies published between 2008 & 2009 [18,19], reporting the clinical outcome & optic toxicity profile after RT delivered with a combination of 2D/3D RT & IMRT; 5 studies published between 2006 and 2012 [22-26], reporting the clinical outcome & optic toxicity after exclusively IMRT; and 3 studies published between 2007 and 2012 comparing the clinical outcome & incidence of optic toxicity after IMRT and non-IMRT techniques [27-29] were selected for the clinical portion of this review. Twelve studies describing the technical aspects of IMRT for paranasal malignancies were also selected for exploration of what would be the best approach to optimize optic pathway sparing [30-41].…”

Section: Resultsmentioning

confidence: 99%

“…Among the 5 studies [22-26] which reported the clinical outcome & toxicity profile after IMRT for sinonasal malignancies, no treatment related blindness was observed. Local control varied from 63.9% to 81% (Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…Among IMRT-only studies, 16% & 56% of the patients in studies by Hoppe et al & Wieger et al respectively, have received chemotherapy as well [25,26]. In the IMRT vs. non-IMRT studies, 35.4% and 15% of the patients reported by Al-Mamgami et al & Chen et al received chemotherapy [28,29].…”

Section: Resultsmentioning

confidence: 99%

“…As an ideal approach to deliver a meaningful dose to the primary tumor or the postoperative tumor bed, and optimally preserve the optic pathway, which is often immediately adjacent to the planning target volume (PTV), intensity modulated radiotherapy (IMRT) has been utilized with excellent short term results [20,21]. Since the adaptation of IMRT into clinical practice, the clinical outcome of IMRT for sinonasal malignancies have been reported by many institutions with improved visual preservation [22-26]. However, there was no consensus on the dose limits for optimal visual preservation.…”

Section: Introductionmentioning

confidence: 99%

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Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation

et al. 2013

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PurposeTo assess if intensity-modulated radiotherapy (IMRT) can possibly lead to improved local control and lower incidence of vision impairment/blindness in comparison to non-IMRT techniques when treating sinonasal malignancies; what is the most optimal dose constraints for the optic pathway; and the impact of different IMRT strategies on optic pathway sparing in this setting.Methods and materialsA literature search in the PubMed databases was conducted in July, 2012.ResultsClinical studies on IMRT and 2D/3D (2 dimensional/3 dimensional) RT for sinonasal malignancies suggest improved local control and lower incidence of severe vision impairment with IMRT in comparison to non-IMRT techniques. As observed in the non-IMRT studies, blindness due to disease progression may occur despite a lack of severe toxicity possibly due to the difficulty of controlling locally very advanced disease with a dose ≤ 70 Gy. Concurrent chemotherapy’s influence on the the risk of severe optic toxicity after radiotherapy is unclear. A maximum dose of ≤ 54 Gy with conventional fractionation to the optic pathway may decrease the risk of blindness. Increased magnitude of intensity modulation through increasing the number of segments, beams, and using a combination of coplanar and non-coplanar arrangements may help increase dose conformality and optic pathway sparing when IMRT is used.ConclusionIMRT optimized with appropriate strategies may be the treatment of choice for the most optimal local control and optic pathway sparing when treating sinonasal malignancy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation

et al. 2013

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“…Yet, in spite of advancements in technology, there has been no significant improvement in the 5-year OS rate since the 1960s. However, retrospective studies have shown reduced radiation-induced toxicity with the use of IMRT in the adjuvant setting and LC rates equal to or better than 3D-CRT [7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In this study, we present the results of 11 patients with SNC treated with definitive RT or CRT, using a two-phase IMRT technique.…”

Section: Discussionmentioning

confidence: 99%

Function preservation and optimal outcomes—definitive chemoradiotherapy with multi-phase treatment planning for locally advanced sinonasal cancer

Burt¹,

Orlandi

Hunt

et al. 2015

J Radiat Oncol

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Objectives The aim of this study is to review radiotherapy (RT) techniques and outcomes for definitive RT or chemoradiotherapy (CRT) for very locally advanced or unresectable sinonasal cancer (SNC) at a single institution. Methods Between 1998 and 2010, there were 11 patients with very locally advanced or unresectable SNCs treated with definitive CRT (8) and RT alone (3) at the University of Utah. CRT was given to stage IVA (5) and stage IVB (3) patients; RT alone was given to stage III (1) and stage IVA (2) patients. All patients were treated with intensity-modulated radiation therapy (IMRT). The median dose was 70.2 Gy (70-72.4 Gy). Most patients underwent two treatment planning phases in order to prevent critical structures from receiving a high dose due to tumor regression and weight loss. The most common chemotherapy was cisplatin 40 mg/m 2 given on a weekly basis for 6-7 cycles. A flexible nasal endoscopy with a biopsy was performed 3 months posttreatment to evaluate tumor response.Results With a median follow-up of 41 months (2-114), overall local control was seen in 8 out of 11 (72.7 %) patients. There was 1 (9.1 %) regional recurrence and 2 (18.2 %) distant metastasis. The definitive CRT or RT was well tolerated with only 2 patients experiencing a grade 3 late toxicity. Conclusion Definitive CRT or RT is feasible for very locally advanced or unresectable SNC. Local control is encouraging with acceptable treatment-related complications when treating with the described two-phase IMRT treatment technique.

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Carcinoma of the Paranasal Sinuses and Nasal Cavity

Siddiqui¹,

Galanopoulos²,

Yao³

2017

Clinical Radiation Oncology

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Intensity-Modulated Radiotherapy for Tumors of the Nasal Cavity and Paranasal Sinuses: Clinical Outcomes and Patterns of Failure

Cited by 52 publications

References 31 publications

Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation

Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation

Function preservation and optimal outcomes—definitive chemoradiotherapy with multi-phase treatment planning for locally advanced sinonasal cancer

Carcinoma of the Paranasal Sinuses and Nasal Cavity

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