Intensity modulated radiotherapy (IMRT) in patients with carcinomas of the paranasal sinuses: clinical benefit for complex shaped target volumes.
BACKGROUND
The aim of the study was to evaluate the clinical outcome of intensity modulated radiotherapy (IMRT) in 46 patients with paranasal sinus tumors with special respect to treatment-related toxicity.


METHODS
We treated 46 patients with histologically proven tumors of the paranasal sinuses with IMRT. Histological classification included squamous cell carcinoma in 6, adenocarcinoma in 8, adenoidcystic carcinoma in 20 and melanoma in 8 patients, respectively. Six patients had been treated with RT during initial therapy after primary diagnosis, and IMRT was performed for the treatment of tumor progression as re-irradiation.


RESULTS
Overall survival rates were 96% at 1 year, 90% at 3 years. Calculated from the initiation of IMRT as primary radiotherapy, survival rates at 1 and 3 years were 95% and 80%. In six patients IMRT was performed as re-irradiation, and survival rate calculated from re-irradiation was 63% at 1 year. Local control rates were 85% at 1, 81% at 2 and 49% at 3 years after primary RT and 50% at 1 year after re-irradiation. Distant metastases-free survival in patients treated with IMRT as primary RT was 83% after 1 and 64% after 3 years. For patients treated as primary irradiation with IMRT, the distant control rate was 83% at 1 year and 0% at 2 years. No severe radiation-induced side-effects could be observed.


CONCLUSIONS
IMRT for tumors of the paranasal sinuses is associated with very good tumor control rates. Treatment-related acute and long-term toxicity can be minimized as compared to historical results with conventional RT.
Combs
Stephanie E
SE
University of Heidelberg, Department of Radiation Oncology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Stephanie.Combs@med.uni-heidelberg.de
Konkel
Stephan
S
Schulz-Ertner
Daniela
D
Münter
Marc W
MW
Debus
Jürgen
J
Huber
Peter E
PE
Thilmann
Christoph
C
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy*; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000532:radiotherapy; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy*; D010256:Paranasal Sinuses / Q000528:radiation effects*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D016896:Treatment Outcome