Visual outcome of accelerated fractionated radiation for advanced sinonasal malignancies employing photons/protons

Radiother Oncol. 2006 Dec;81(3):243-9. doi: 10.1016/j.radonc.2006.09.009. Epub 2006 Oct 16.


Purpose: To investigate the visual outcomes of patients with advanced sinonasal malignancies treated with proton/photon accelerated fractionated radiation (AFR).

Patients and methods: Between 1991 and 2001, AFR was used to treat 36 patients with advanced stage primary (n=33) or recurrent (n=3) nasal or paranasal malignant tumors. Full ophthalmologic follow-up was documented. The median dose to the gross tumor volume (GTV) was 69.6 CGE (range 60.8-77). Visual complications were graded according to the National Cancer Institute Common Toxicity Criteria (CTC) and the late effects of normal tissue (LENT) scoring systems. The median follow-up was 52.4 months (range 17-122.8).

Results: Thirteen patients developed late visual/ocular toxicity. Cataracts were LENT grade 1 and 3 in 2 patients and 1 patient, respectively. One LENT grade 1 vascular retinopathy and 1 optic neuropathy were also observed. Three and five patients presented with nasolacrimal duct stenosis (CTC grade 2, 2 patients; CTC grade 3, 1 patient) and dry-eye syndrome (CTC grade 1, 1 patient; CTC grade 2, 4 patients), respectively. The 3- and 5-year probability of LENT/CTC grade > or =2 visual toxicity were 15.8+/-6.7% and 20.7+/-7.8%, respectively.

Conclusions: AFR for locally advanced nasal cavity and paranasal sinus tumors enables delivery of 70 CGE to the tumor with acceptable ophthalmologic complications.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Transitional Cell / complications
  • Carcinoma, Transitional Cell / radiotherapy
  • Dose Fractionation, Radiation
  • Eye Diseases / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / radiotherapy*
  • Paranasal Sinus Neoplasms / complications
  • Paranasal Sinus Neoplasms / radiotherapy*
  • Photons / therapeutic use*
  • Proton Therapy*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Conformal
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome


  • Protons