Postoperative intensity-modulated radiation therapy for cancers of the paranasal sinuses, nasal cavity, and lacrimal glands: technique, early outcomes, and toxicity

Head Neck. 2008 Jul;30(7):925-32. doi: 10.1002/hed.20800.

Abstract

Background: Our aim was to review Memorial Sloan-Kettering Cancer Center's experience with postoperative intensity-modulated radiotherapy (IMRT) for paranasal sinus, nasal cavity, and lacrimal gland cancer and report dosimetric measures, toxicity, and outcomes.

Methods: Between September 2000 and June 2006, 37 patients with paranasal sinus, nasal cavity, or lacrimal gland cancer underwent postoperative IMRT. Median values were as follows: prescription dose, 60 Gy (range, 50-70); PTV(D95), 99% (range, 79-101%); optic nerve Dmax, 53 Gy (range, 2-54); optic chiasm Dmax, 51Gy (range, 2-55). Acute and late toxicities were scored by Radiation Therapy Oncology Group morbidity criteria.

Results: Median follow-up was 28 months. Two-year local progression-free and overall survivals were 75% and 80%. No early- or late-grade 3/4 radiation-induced ophthalmologic toxicity occurred.

Conclusions: Preliminary results show that adjuvant IMRT in these patients is feasible, allowed for excellent planning target volume (PTV) coverage, and minimized dose delivered to optic structures. Longer follow-up is warranted to assess the extent of late effects and outcomes.

MeSH terms

  • Adult
  • Aged
  • Eye Neoplasms / mortality
  • Eye Neoplasms / pathology
  • Eye Neoplasms / radiotherapy*
  • Eye Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Lacrimal Apparatus / pathology
  • Male
  • Middle Aged
  • Nasal Cavity / pathology
  • Nose Neoplasms / mortality
  • Nose Neoplasms / pathology
  • Nose Neoplasms / radiotherapy*
  • Nose Neoplasms / surgery
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / radiotherapy*
  • Paranasal Sinus Neoplasms / surgery
  • Postoperative Care / methods
  • Probability
  • Radiation Injuries / prevention & control
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Adjuvant
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / methods*
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome