Fistula formation after postoperative radiation treatment for paranasal sinus cancer Journal Article


Authors: Terezakis, S. A.; Bohle, G. C.; Lee, N. Y.
Article Title: Fistula formation after postoperative radiation treatment for paranasal sinus cancer
Abstract: Postoperative radiation is frequently used in the treatment paradigm for paranasal sinus tumors. The development of 3-dimensional conformal radiation treatment and intensity modulated radiotherapy (IMRT) has facilitated the delivery of high doses required for local control of these lesions while simultaneously decreasing toxicity. At Memorial Sloan-Kettering Cancer Center, a radiation dose of 70 Gy is routinely prescribed to gross tumor, and 59.4 Gy is prescribed to a clinical target volume at high risk for subclinical disease and 54 Gy is delivered to a clinical target volume at low risk for subclinical disease. Fistula formation can occur with the delivery of postoperative radiation treatment despite the use of IMRT. Prosthesis fabrication can be used in the short-term management of this unfortunate complication with an acceptable cosmetic result. Patients should be aware of this potential toxicity, which can develop in spite of appropriate management and acceptable dosimetry. Nonetheless, combined modality therapy is recommended for aggressive treatment of paranasal sinus tumors to inhibit local progression. This report describes the clinical scenario and management of the rare incidence of fistula formation after radiation for paranasal sinus malignancy. © 2008 Lippincott Williams & Wilkins, Inc.
Keywords: review; intensity modulated radiation therapy; postoperative period; cutaneous fistula; fistula; cancer radiotherapy; radiation dose; radiotherapy, adjuvant; follow up; cancer diagnosis; radiation injury; patient care; radiotherapy, intensity-modulated; radiotherapy, conformal; paranasal sinus cancer; paranasal sinus neoplasms; prostheses and implants; radiation toxicity in head and neck cancer; side effects of sinus cancer treatment; oral fistula; oroantral fistula; paranasal sinus diseases
Journal Title: American Journal of Clinical Oncology
Volume: 31
Issue: 2
ISSN: 0277-3732
Publisher: Lippincott Williams & Wilkins  
Date Published: 2008-04-01
Start Page: 199
End Page: 204
Language: English
DOI: 10.1097/COC.0b013e31815aff43
PUBMED: 18391607
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 17 November 2011" - "CODEN: AJCOD" - "Source: Scopus"
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  1. George C Bohle
    17 Bohle
  2. Nancy Y. Lee
    871 Lee