Influence of Postsurgical Residual Tumor Volume on Local Control in Radiotherapy for Maxillary Sinus Cancer

16518 Background: The aim was to study the influence of post-surgical gross residual tumor volume on local control of maxillary sinus cancer treated with radiotherapy combined with debulking surgery. Methods: Twenty-five patients with squamous cell carcinoma of the maxillary sinus treated by combined surgery and radiotherapy (50–65 Gy, median 60 Gy). Gross residual tumor volume (GRTV) after surgery was measured on computed tomograms obtained after surgery. Patients were classified according to GRTV as follows: group A, GRTV = 0 (microscopic residual, n = 5); group B, GRTV <10 cm3 (n = 11); group C, 10–40 cm3 (n = 5); and group D, =40 cm3 (n = 4). The relationship between local control and GRTV was analyzed using univariate and multivariate analysis. Results: The 2-year local control rate for all patients was 64%. The differences in local control rates between groups A, B and C were not significant (P > 0.05), but the rate was significantly lower in group D than in the other groups (65% at 2 years vs. 25% at 1 year, P < 0.001). Multivariate analysis showed that GRTV (P = 0.002) and histological differentiation (poorly differentiated histology was favorable, P = 0.035) were independent prognostic factors and that tumor stage and the sequence of treatment were not. Conclusions: Our data suggest that adequate, not complete, debulking associated with the proper dose of radiotherapy can provide satisfactory local control for patients with squamous cell carcinoma of the maxillary sinus. No significant financial relationships to disclose.

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A Case of Stevens-Johnson Syndrome Developing during Chemoradiotherapy for Maxillary Sinus Cancer

Nippon Jibiinkoka Gakkai Kaiho ◽

10.3950/jibiinkoka.118.1436 ◽

2015 ◽

Vol 118 (12) ◽

pp. 1436-1442 ◽

Cited By ~ 2

Author(s):

Kousuke Yoshifuku ◽

Kengo Nishimoto ◽

Tsutomu Matsuzaki ◽

Shigeto Matsushita

Keyword(s):

Maxillary Sinus ◽

Stevens Johnson Syndrome ◽

Johnson Syndrome ◽

Maxillary Sinus Cancer ◽

Sinus Cancer

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Invasion of the pterygoid plates: an indicator for regional lymph node failure in maxillary sinus cancer

Radiation Oncology ◽

10.1186/s13014-020-01726-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yasuo Kosugi ◽

Terufumi Kawamoto ◽

Masaki Oshima ◽

Mitsuhisa Fujimaki ◽

Shinichi Ohba ◽

...

Keyword(s):

Lymph Node ◽

Oral Cavity ◽

Maxillary Sinus ◽

Regional Lymph Node ◽

Locally Advanced ◽

Intraarterial Chemotherapy ◽

Node Failure ◽

Long Term Treatment ◽

Maxillary Sinus Cancer ◽

Sinus Cancer

Abstract Background The aim of this study was to evaluate the long-term treatment results of combined superselective intraarterial chemotherapy and radiation therapy for advanced maxillary sinus cancer (MSC) and the incidence of regional lymph node failure, and to reveal the clinical and anatomical predictive factors for metastasis. Methods We retrospectively evaluated 55 consecutive patients with locally advanced squamous cell carcinoma of the maxillary sinus who were treated with external radiotherapy and superselective intraarterial chemotherapy. Elective nodal irradiation (ENI) was performed only in the clinical node-positive (cN+) cases and not in the clinical node-negative (cN0) cases. Results: Thirty-eight patients were cN0, and 17 were cN+ at diagnosis. Regional lymph node metastases occurred in 7 of 38 patients with cN0, and 2 of 17 with cN+ during the median follow-up period of 36 months. There were more cases of high-grade (3 or 4) late adverse events in the ENI group than in the non-ENI group (13% vs. 41%, respectively; p = 0.03). In cN0 cases without ENI, invasion of the pterygoid plates (57% vs. 90%; p < 0.01) and oral cavity (35% vs. 92%, with invasion vs without invasion, respectively; p = 0.02) was significantly correlated with a low 5-year regional recurrence-free rate. Conclusions Patients with MCS and invasion of the pterygoid plates and oral cavity can be considered appropriate candidates for ENI.

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Superselective Intra-arterial Chemotherapy for Advanced Maxillary Sinus Cancer

Journal of Computer Assisted Tomography ◽

10.1097/rct.0b013e3181151331 ◽

2008 ◽

Vol 32 (3) ◽

pp. 397-402 ◽

Cited By ~ 6

Author(s):

Etsushi Iida ◽

Munemasa Okada ◽

Toshifumi Mita ◽

Matakazu Furukawa ◽

Katsuyoshi Ito ◽

...

Keyword(s):

Maxillary Sinus ◽

Maxillary Sinus Cancer ◽

Sinus Cancer

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Treatment outcome of maxillary sinus cancer

Rare Tumors ◽

10.4081/rt.2009.e36 ◽

2009 ◽

Vol 1 (2) ◽

pp. 110-114 ◽

Cited By ~ 6

Author(s):

Hye Sung Won ◽

Sang Hoon Chun ◽

Bum-soo Kim ◽

So Ryoung Chung ◽

Ie Ryung Yoo ◽

...

Keyword(s):

Treatment Outcome ◽

Maxillary Sinus ◽

Maxillary Sinus Cancer ◽

Sinus Cancer

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Maxillary Sinus Cancer pN3 TNM Finding v6 and v7

10.32388/unwscn ◽

2020 ◽

Author(s):

Keyword(s):

Maxillary Sinus ◽

Maxillary Sinus Cancer ◽

Sinus Cancer

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Dose distribution of intensity-modulated proton therapy with and without a multi-leaf collimator for the treatment of maxillary sinus cancer: a comparative effectiveness study

Radiation Oncology ◽

10.1186/s13014-019-1405-y ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Soichi Sugiyama ◽

Kuniaki Katsui ◽

Yuki Tominaga ◽

Takahiro Waki ◽

Norihisa Katayama ◽

...

Keyword(s):

Optic Nerve ◽

Maxillary Sinus ◽

Proton Therapy ◽

Normal Tissue ◽

Optic Chiasm ◽

Intensity Modulated Proton Therapy ◽

Multi Leaf Collimator ◽

Maxillary Sinus Cancer ◽

The Mean ◽

Sinus Cancer

Abstract Background Severe complications, such as eye damage and dysfunciton of salivary glands, have been reported after radiotherapy among patients with head and neck cancer. Complications such as visual impairment have also been reported after proton therapy with pencil beam scanning (PBS). In the case of PBS, collimation can sharpen the penumbra towards surrounding normal tissue in the low energy region of the proton beam. In the current study, we examined how much the dose to the normal tissue was reduced by when intensity-modulated proton therapy (IMPT) was performed using a multi-leaf collimator (MLC) for patients with maxillary sinus cancer. Methods Computed tomography findings of 26 consecutive patients who received photon therapy at Okayama University Hospital were used in this study. We compared D2% of the region of interest (ROI; ROI-D2%) and the mean dose of ROI (ROI-mean) with and without the use of an MLC. The organs at risk (OARs) were the posterior retina, lacrimal gland, eyeball, and parotid gland. IMPT was performed for all patients. The spot size was approximately 5–6 mm at the isocenter. The collimator margin was calculated by enlarging the maximum outline of the target from the beam’s eye view and setting the margin to 6 mm. All plans were optimized with the same parameters. Results The mean of ROI-D2% for the ipsilateral optic nerve was significantly reduced by 0.48 Gy, and the mean of ROI-mean for the ipsilateral optic nerve was significantly reduced by 1.04 Gy. The mean of ROI-mean to the optic chiasm was significantly reduced by 0.70 Gy. The dose to most OARs and the planning at risk volumes were also reduced. Conclusions Compared with the plan involving IMPT without an MLC, in the dose plan involving IMPT using an MLC for maxillary sinus cancer, the dose to the optic nerve and optic chiasm were significantly reduced, as measured by the ROI-D2% and the ROI-mean. These findings demonstrate that the use of an MLC during IMPT for maxillary sinus cancer may be useful for preserving vision and preventing complications.

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