Outcomes of Sinonasal Cancer Treated With Proton Therapy

Dagan, Roi; Bryant, Curtis; Li, Zuofeng; Yeung, Daniel; Justice, Jeb M.; Dzieglewiski, Peter; Werning, John W.; Fernandes, Rui; Pirgousis, Phil; Lanza, Donald C.; Morris, Christopher G.; Mendenhall, William M.

doi:10.1016/j.ijrobp.2016.02.019

Cited by 63 publications

(69 citation statements)

References 25 publications

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“…New irradiation techniques such as or proton therapy are being evaluated and offer encouraging dosimetric and clinical outcomes . However, proton therapy is still out of reach for most centers.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,13 New irradiation techniques such as or proton therapy are being evaluated and offer encouraging dosimetric and clinical outcomes. [26][27][28][29] However, proton therapy is still out of reach for most centers. Furthermore, the highly localized dose deposition makes proton therapy sensitive to treatment uncertainties as large density heterogeneities and anatomical uncertainties, such as variations in the filling of the nasal cavities and paranasal sinuses.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative volumetric modulated arc therapy for sinonasal cancer: Improved survival compared with 3D conformal radiation therapy

et al. 2018

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Background Prospective evaluation of the results of volumetric modulated arc therapy (VMAT) for sinonasal cancer compared to 3D conformal radiation therapy (3DCRT). Materials and Methods We prospectively evaluated 34 patients (pts) treated with postoperative VMAT with simultaneous integrated boost (SIB; RapidArc) from 2011 to 2015. These pts were retrospectively compared with 24 pts treated with 3DCRT from 2003 to 2011. The two sets were not significantly different on sex, mean age, tumor site, stage, histology. Efficacy and toxicity were evaluated. Results Median follow‐up was 45 months (range: 6‐143 months). Three‐year overall survival was 85.2% in VMAT‐SIB versus 65.2% in 3DCRT (P = .02). Three‐year local control was 81.2% in VMAT‐SIB versus 62.5% in 3DCRT (P = .04). There was a reduction of acute (<0.09) and late (0.03) ocular toxicity of grade ≥ 2 for pts with VMAT‐SIB. Conclusion VMAT significantly improved local control and overall survival in sinonasal cancer with lower rate of toxicity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative volumetric modulated arc therapy for sinonasal cancer: Improved survival compared with 3D conformal radiation therapy

et al. 2018

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“…74 More recent reports show that proton-beam therapy for treatment of sinonasal cancer is associated with good locoregional control, freedom from distant metastasis, and acceptable toxicity. 75,76 Specifically for NPC, proton therapy has established dosimetric superiority, although trials are ongoing to determine the level of clinical benefit. 77 However, without high-quality prospective comparative data, it is premature to conclude that proton therapy has been established as superior to other modern radiation techniques, such as IMRT.…”

Section: Radiation Therapymentioning

confidence: 99%

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018

Colevas¹,

Yom²,

Pfister³

et al. 2018

J Natl Compr Canc Netw

459

411

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The NCCN Guidelines for Head and Neck (H&N) Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided for occult primary of the H&N, and separate algorithms have been developed by the panel for very advanced H&N cancers. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding evaluation and treatment of nasopharyngeal carcinoma.

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“…Significant treatment‐related toxicity is less common with modern radiotherapy techniques. It is interesting to note that recent advances in radiotherapy have demonstrated significantly improved outcomes with minimal long‐term toxicity …”

Section: Introductionmentioning

confidence: 99%

“…It is interesting to note that recent advances in radiotherapy have demonstrated significantly improved outcomes with minimal long-term toxicity. 3,[12][13][14][15][16] The optimal sequencing of chemotherapy and radiotherapy for patients with sinonasal carcinoma remains controversial. 17 Small reports have shown a benefit for induction chemotherapy, 8,[18][19][20][21][22] and numerous institutional and multiinstitutional series have shown a benefit for adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive comparative analysis of treatment modalities for sinonasal malignancies

Robin

Jones

Gordon

et al. 2017

Cancer

131

170

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BACKGROUND: Sinonasal malignancies are a rare and heterogeneous group of tumors for which there is a paucity of robust data with which to guide management decisions. The authors used the National Cancer Data Base to better understand the presenting characteristics of these tumors and to compare outcomes by treatment modality. METHODS: The National Cancer Data Base was queried for sinonasal malignancies diagnosed between 2004 and 2012. Overall survival was assessed using multivariate analyses and propensity score matching. RESULTS: A total of 11,160 patients were identified for the initial analysis. The majority were male, aged 40 to 69 years, with tumors of the nasal cavity or maxillary sinus. Squamous cell histology was most common. The majority of patients presented with advanced tumor stage but without locoregional lymph node or distant metastases. Treatment modalities were compared for squamous cell carcinomas. In multivariate analysis, compared with surgery alone, patients who received adjuvant radiotherapy (hazard ratio [HR], 0.658 [P<.001]), adjuvant chemoradiotherapy (HR, 0.696 [P=.002]), or neoadjuvant therapy (HR, 0.656 [P = .007]) had improved overall survival. Patients who received radiotherapy alone (HR, 1.294 [P=.001]) or chemotherapy alone (HR, 1.834 [P<.001]) had worse outcomes. These findings were validated in propensity score matching. It is important to note that neoadjuvant chemoradiotherapy was associated with achieving a negative surgical margin (odds ratio, 2.641 [P=.045]). CONCLUSIONS: Surgery is the mainstay of therapy for patients with sinonasal malignancies, but multimodality therapy is associated with improved overall survival.

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Outcomes of Sinonasal Cancer Treated With Proton Therapy

Cited by 63 publications

References 25 publications

Postoperative volumetric modulated arc therapy for sinonasal cancer: Improved survival compared with 3D conformal radiation therapy

Postoperative volumetric modulated arc therapy for sinonasal cancer: Improved survival compared with 3D conformal radiation therapy

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018

A comprehensive comparative analysis of treatment modalities for sinonasal malignancies

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