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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Contemporary series of patients with nasal cavity and paranasal sinus tumors

Contemporary series of patients with nasal cavity and paranasal sinus tumors
Site: MSKCC[1] UCSF[2] MDACC[3] UF[4] Ghent University[5] UCLA and Geneva Switzerland[6] UFHPTI[7]
Year 2007 2007 2008 2009 2012 2012 2016
Number of patients 85 127 68 109 130 220 84
Patients with nasal cavity tumors (%) 28 28 100 63 24 30 80
Stage (%)
T1-T2 12 13 60 39 30 34 6
T3-T4 81 87 34 61 62 65 94
Tx – – 6 – 8 – –
Node positive 7 9 9 10 3 2 9
Recurrent 7 – – – – – 8
Histology (%)
Squamous cell 49 65 66 29 18 57 26
Adenoid cystic 13 22 18 15 4 16 17
Adenocarcinoma – 13 12 8 63 11 10
Sarcoma 11 – – – – – –
Sinonasal undifferentiated carcinoma – – 4 13 6 14 8
Olfactory neuroblastoma 8 – – 20 8 – 27
Other 20 – – 15 1 2 12
Treatment (%)
RT alone – 16 47 52 22 28 13
Preoperative RT – 7 4 7 – – –
Postoperative RT 100 77 49 41 78 52 87
Surgery without RT – – – – – 20 –
Median RT dose 63 Gy RT alone, 66 Gy;
Post-op RT, 63 Gy		 RT alone, 65 Gy;
Post-op RT, 58 Gy		 RT alone, 70 Gy;
Post-op RT, 64.8 Gy		 70 Gy   73.8 Gy (RBE) protons
Five-year local control (%) 62 62 86 63 59 57 83 (three years)
Five-year regional control (%) 87 – 92 91 – – 94 (three years)
Five-year disease-free survival (%) 55 54 86 – 43 – 73 (three years)
Five-year overall survival (%) 67 52 82 55 64 63 63 (three years)
Notes Worse outcomes for squamous cell carcinoma, cribriform plate or orbit invasion, and positive nodes. 16% of postoperative RT patients had gross residual disease; 15% of all patients received chemotherapy. GTR improved local control compared with STR (65 versus 44%). Worse outcomes for nonsquamous cell histologies and T3-4 tumors. 19% distant metastasis rate; 30% severe complications rate. Outcomes significantly improved with post-op RT compared with RT alone. Only two regional failures. Intensity-modulated RT improved outcomes. Only 3% of patients failed in nodes. Worse prognosis in nonnasal cavity primaries, squamous cell, and undifferentiated histologies, as well as advanced T stage. 90% local control in patients without gross disease. 24% grade 3 or worse toxicity.
MSKCC: Memorial Sloan-Kettering Cancer Center (New York, NY); MDACC: MD Anderson Cancer Center (Houston, TX); UCSF: University of California San Francisco (San Francisco, CA); UF: University of Florida (Gainesville, FL); UCLA: University of California Los Angeles (Los Angeles, CA); UFHPTI: University of Florida Health Proton Therapy Institute (Jacksonville, FL); RT: radiotherapy; Post-op: postoperative; RBE: relative biological effectiveness; GTR: gross total resection; STR: subtotal resection.
References:
  1. Hoppe BS, Stegman LD, Zelefsky MJ, et al. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting--the MSKCC experience. Int J Radiat Oncol Biol Phys 2007; 67:691.
  2. Chen AM, Daly ME, Bucci MK, et al. Carcinomas of the paranasal sinuses and nasal cavity treated with radiotherapy at a single institution over five decades: are we making improvement? Int J Radiat Oncol Biol Phys 2007; 69:141.
  3. Allen MW, Schwartz DL, Rana V, et al. Long-term radiotherapy outcomes for nasal cavity and septal cancers. Int J Radiat Oncol Biol Phys 2008; 71:401.
  4. Mendenhall WM, Amdur RJ, Morris CG, et al. Carcinoma of the nasal cavity and paranasal sinuses. Laryngoscope 2009; 119:899.
  5. Duprez F, Madani I, Morbee L, et al. IMRT for sinonasal tumors minimizes severe late ocular toxicity and preserves disease control and survival. Int J Radiat Oncol Biol Phys 2012; 83:252.
  6. Dulguerov P, Jacobsen MS, Allal AS, et al. Nasal and paranasal sinus carcinoma: are we making progress? A series of 220 patients and a systematic review. Cancer 2001; 92:3012.
  7. Dagan R, Bryant C, Li Z, et al. Outcomes of sinonasal cancer treated with proton therapy. Int J Radiat Oncol Biol Phys 2016; 95:377.
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