Perioperative image-adapted brachytherapy for the treatment of paranasal sinus and nasal cavity malignancies

Introduction:

Sinonasal malignancies are a rare group of cancers often associated with late presentation and poor prognosis. In the past, there was little progress regarding survival rate, and often, multimodal treatment regimens are required. The aim of this study was to evaluate the clinical outcome of perioperative image-adapted brachytherapy as part of a multidisciplinary treatment regimen for the therapy of sinonasal cancer.

Methods:

Since 2006, patients with sinonasal cancer were offered a multimodal treatment concept including head and neck surgery, perioperative IABT with or without external beam radiation therapy, and chemotherapy. In a retrospective study, such patients were analyzed for survival rate, tumor control, and toxicity of the interdisciplinary treatment.

Results:

Sixty-five consecutive patients were analyzed. The majority of patients (65%) were treated for a primary tumor and 62% presented with tumor Stages IIIeIV. The mean follow-up time with IABT was 48 months. Overall survival estimate was 78% after 4 years. Relapse-free survival was 85.7% at 4 years. Locoregional tumor control was 88.4% at 4 years. On univariate analysis, a significant better overall survival rate was found in patients treated for primary, but not recurrent, sinonasal cancer.

Conclusions:

Interdisciplinary perioperative IABT is associated with excellent locoregional control and survival rates. IABT is well tolerated and shows low toxicity. The implementation of perioperative IABT into multimodal treatment regimens improves the oncologic outcome

Publikationsverlauf

Publikationsdatum:
23. April 2019 (online)