A multidimensional cohort study of late toxicity after intensity modulated radiotherapy for sinonasal cancer

Sharma, M.B.; Jensen, Kenneth; Urbak, Steen F.; Funding, Mikkel; Johansen, Jørgen; Bechtold, Dorte; Amidi, Ali; Eskildsen, Simon Fristed; Jørgensen, Jens Otto Lunde; Grau, Cai

doi:10.1016/j.radonc.2020.07.029

Cited by 15 publications

(22 citation statements)

References 50 publications

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“…While early IMRT series may have underestimated toxicity rates [ 43 , 44 , 45 , 46 , 47 ], other series report grade ≥ 2 late toxicities in the order of 28% [ 36 ]. Grade 2+ visual deterioration is reported in about 12–20% of patients [ 36 , 38 , 48 , 49 , 50 ]; 63% impaired olfactory function [ 50 ]; ear loss in 8–46% [ 5 , 51 , 52 ]); hormonal deficiencies in 22–62% including hypopituitarism in 24% [ 50 , 53 ]; cognitive dysfunction in up to 77% affecting short-term memory and speech; and fatigue in 18% [ 54 , 55 ]. According to Hamilton et al, sinonasal neoplasms are associated with significant symptoms during RT including pain, mucositis and dysgeusia [ 56 ].…”

Section: Radiotherapymentioning

confidence: 99%

“…Dose-response associations have been found between visual acuity impairment and the optic nerve and between fatigue and the temporal lobes after IMRT for sinonasal cancer but not for hypopituitarism or impaired olfactory function [ 50 , 57 ], possibly due to prescription dose to tumor nearby exceeding threshold dose for the given organ. Moreover, 11% of patients had structural abnormalities in irradiated areas of the brain, and impaired cognitive function was present in 63% of patients.…”

Section: Radiotherapymentioning

confidence: 99%

“…Limited experience also suggests that quality of life (QoL) may return to pretherapeutic levels after 12 months using IMRT [ 36 ]. Impaired cognitive function as well as fatigue and insomnia were affected the most in QoL analyses [ 50 ]. Grade 3+ toxicity seems to be more likely in T4 tumors in relation to tumor stage and extensions, where compromise on tumor control may not be acceptable [ 36 , 50 ].…”

Section: Radiotherapymentioning

confidence: 99%

“…Impaired cognitive function as well as fatigue and insomnia were affected the most in QoL analyses [ 50 ]. Grade 3+ toxicity seems to be more likely in T4 tumors in relation to tumor stage and extensions, where compromise on tumor control may not be acceptable [ 36 , 50 ]. However, there seems to exist some latitude to apply stronger dose constraints to organs without jeopardizing tumor control [ 50 ].…”

Section: Radiotherapymentioning

confidence: 99%

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Precision Postoperative Radiotherapy in Sinonasal Carcinomas after Endonasal Endoscopic Surgery

Thariat

Carsuzaa

Marcy³

et al. 2021

Cancers

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Radiotherapy plays an important role in the treatment of sinonasal cancer, mainly in the adjuvant setting after surgical resection. Many technological approaches have been described, including intensity-modulated radiotherapy, concomitant chemoradiotherapy, charged particle therapy or combined approaches. The choice is based on general criteria related to the oncological results and morbidity of each technique and their availability, as well as specific criteria related to the tumor (tumor extensions, pathology and quality of margins). The aims of this review are: (i) to provide an overview of the radiotherapy techniques available for the management of sinonasal malignant tumors and (ii) to describe the constraints and opportunities of radiotherapy owing to the recent developments of endonasal endoscopic surgery. The indication and morbidity of the different techniques will be discussed based on a critical literature review.

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Section: Radiotherapymentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

See 2 more Smart Citations

Precision Postoperative Radiotherapy in Sinonasal Carcinomas after Endonasal Endoscopic Surgery

Thariat

Carsuzaa

Marcy³

et al. 2021

Cancers

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“…Radiation of OARs might cause permanent and potentially severe late toxicity. As described in a cohort of SNC patients [12,13], late toxicity might include cognitive impairment, deteriorated visual acuity, hypopituitarism and olfactory dysfunction. The need to spare OARs might hinder the delivery of sufficient dose to the tumours, which together with the dynamic anatomy pose a major challenge in RT of SNC.…”

Section: Introductionmentioning

confidence: 97%

Air variability in maxillary sinus during radiotherapy for sinonasal carcinoma

Sharma

Perez

Holm

et al. 2021

Clinical and Translational Radiation Oncology

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Introduction: The aim was to characterise patterns and predictability of aeration changes in the ipsilateral maxillary sinus during intensity-modulated radiotherapy (IMRT) for sinonasal cancer (SNC), and in a sample evaluate the dosimetric effects of aeration changes for both photon and proton therapy. Materials and methods: The study included patients treated with IMRT for SNC in a single institution in 2009-2017. The volume of air in the ipsilateral maxillary sinus was recorded in 1578 daily cone beam computer tomography (CBCT) from 53 patients. Patterns of changing air volumes were categorised as 'stable', increasing', 'decreasing', or 'erratic'. For the prediction analysis, categorisation was performed based both on the entire treatment course and the first five fractions (F1-5). Photon and proton therapy plans were generated for four patients, the one from each category with the largest aeration variation. Synthetic CT images were generated for each CBCT and all plans were recalculated on the daily synthetic CTs. Results: The absolute volume of air varied considerably during the treatment course, ranging from 0 to 25.9 cm 3 . Changes within a single participant varied in the range of 0-18.7 cm 3 . In the categorisation of patterns, most patients had increasing aeration of the sinus. Generally, patterns of aeration could not be predicted from F1-5. Patients categorised as increasing in F1-5 had the best prediction, with 78% predicted correctly as increasing for the entire treatment course. The numeric correlation coefficients for target coverage and air volume were low for 3/4 scenarios (photons 0.03-0.23, protons 0.26-0.48). No straightforward correlation between the dosimetric effect and the volume changes could be detected in the sample test of four patients for neither photon nor proton therapy. Conclusion: The variation of aeration was large and unpredictable. No clear dosimetric consequences of the aeration variation were evident for neither IMRT nor proton therapy for the patients investigated.

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International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Kuan

Wang

Adappa

et al. 2024

Int Forum Allergy Rhinol

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BackgroundSinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology‐based topics spanning the field.MethodsIn accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence‐Based Review with Recommendations, Evidence‐Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses format, and completed sections underwent a thorough and iterative consensus‐building process. The final document underwent rigorous synthesis and review prior to publication.ResultsThe ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology‐based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.ConclusionAs an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.This article is protected by copyright. All rights reserved

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A multidimensional cohort study of late toxicity after intensity modulated radiotherapy for sinonasal cancer

Cited by 15 publications

References 50 publications

Precision Postoperative Radiotherapy in Sinonasal Carcinomas after Endonasal Endoscopic Surgery

Precision Postoperative Radiotherapy in Sinonasal Carcinomas after Endonasal Endoscopic Surgery

Air variability in maxillary sinus during radiotherapy for sinonasal carcinoma

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

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