Unresectable Carcinoma of the Paranasal Sinuses: Outcomes and Toxicities

Journal Article · Sat Nov 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.038· OSTI ID:21128207

Hoppe, Bradford S; Nelson, Carl J; Gomez, Daniel R; Stegman, Lauren D; Wu, Abraham J; Wolden, Suzanne L ^[1]; Pfister, David G ^[2]; Zelefsky, Michael J ^[1]; Shah, Jatin P; Kraus, Dennis H ^[3]

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1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
2. Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
3. Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

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.

• OSTI ID: 21128207
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
DISEASE INCIDENCE
DOSE EQUIVALENTS
IRRADIATION
METASTASES
NECK
NOSE
PATIENTS
RADIOTHERAPY
SINUSES
TOXICITY