Unresectable carcinoma of the paranasal sinuses: Outcomes and toxicities Journal Article
| Authors: | Hoppe, B. S.; Nelson, C. J.; Gomez, D. R.; Stegman, L. D.; Wu, A. J.; Wolden, S. L.; Pfister, D. G.; Zelefsky, M. J.; Shah, J. P.; Kraus, D. H.; Lee, N. Y. |
| Article Title: | Unresectable carcinoma of the paranasal sinuses: Outcomes and toxicities |
| Abstract: | Purpose: To evaluate long-term outcomes and toxicity in patients with unresectable paranasal sinus carcinoma treated with radiotherapy, with or without chemotherapy. Methods and Materials: Between January 1990 and December 2006, 39 patients with unresectable Stage IVB paranasal sinus carcinoma were treated definitively with chemotherapy plus radiotherapy (n = 35, 90%) or with radiotherapy alone (n = 4, 10%). Patients were treated with three-dimensional conformal radiotherapy (n = 18, 46%), intensity-modulated radiotherapy (n = 12, 31%), or conventional radiotherapy (n = 9, 23%) to a median treatment dose of 70 Gy. Most patients received concurrent platinum-based chemotherapy (n = 32, 82%) and/or concomitant boost radiotherapy (n = 29, 74%). Results: With a median follow-up of 90 months, the 5-year local progression-free survival, regional progression-free survival, distant metastasis-free survival, disease-free survival, and overall survival were 21%, 61%, 51%, 14%, and 15%, respectively. Patients primarily experienced local relapse (n = 25, 64%), mostly within the irradiated field (n = 22). Nine patients developed neck relapses; however none of the 4 patients receiving elective neck irradiation had a nodal relapse. In 13 patients acute Grade 3 mucositis developed. Severe late toxicities occurred in 2 patients with radionecrosis and 1 patient with unilateral blindness 7 years after intensity-modulated radiation therapy (77 Gy to the optic nerve). The only significant factor for improved local progression-free survival and overall survival was a biologically equivalent dose of radiation ≥65 Gy. Conclusions: Treatment outcomes for unresectable paranasal sinus carcinoma are poor, and combined-modality treatment is needed that is both more effective and associated with less morbidity. The addition of elective neck irradiation may improve regional control. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; clinical article; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; survival analysis; young adult; overall survival; three dimensional; intensity modulated radiation therapy; cisplatin; fluorouracil; cancer combination chemotherapy; patient selection; cancer radiotherapy; radiation dose; combined modality therapy; chemotherapy; cancer staging; follow up; carboplatin; etoposide; mucosa inflammation; radiotherapy dosage; radiotherapy; radiation injury; biotechnology; cetuximab; distant metastasis; ifosfamide; vinblastine; survivors; docetaxel; intensity-modulated radiotherapy; radiotherapy, intensity-modulated; irradiation; long term care; cancer relapse; platinum; health; radiotherapy, conformal; platinum compounds; toxicity; mitomycin; computer assisted radiotherapy; paranasal sinus neoplasms; chemoradiation; mucositis; hearing impairment; eye protection; intensity-modulated radiation therapy; hearing loss; radiation necrosis; paranasal sinus; nose neoplasms; paranasal sinuses; ototoxicity; nasal cavity; platinum-based chemotherapy; progression-free survival; otitis media; three-dimensional conformal radiotherapy; equivalent dose; paranasal sinus carcinoma; unresectable; electrotherapeutics; optic nerves; radiotherapy alone; significant factor; with or without; external otitis; unilateral blindness |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 72 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-11-01 |
| Start Page: | 763 |
| End Page: | 769 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2008.01.038 |
| PUBMED: | 18395361 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 11" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
