Intensity-Modulated Radiotherapy for Sinonasal Tumors: Ghent University Hospital Update

Madani, Indira; Bonte, Katrien; Vakaet, Luc; Boterberg, Tom; Neve, Wilfried De

doi:10.1016/j.ijrobp.2008.04.037

Cited by 112 publications

(111 citation statements)

References 25 publications

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“…Recent reports [42][43][44][45][46][47][48][49] delivering higher doses (60-70 Gy) with IMRT suggest potentially improved local control (60-85%) as well as overall survival (50-90%), at 2-4 years, albeit with shorter follow-up, with significantly reduced ocular toxicity (dry-eye syndrome and optic neuropathy) consistent with the dose-volume-toxicity profile of the lacrimal and optic apparatus (Table 3). Interesting applications of IMRT that currently evolving (Table 4) include curative intent re-irradiation in the setting of a delayed locoregional recurrence or the emergence of a second new primary in a previously irradiated head-neck mucosal site;…”

Section: Current Best Evidencementioning

confidence: 67%

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Gupta

Agarwal

Susovan

et al. 2010

Indian J Surg Oncol

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Intensity-modulated radiation therapy (IMRT) is a revolutionary new paradigm that aims at improving the therapeutic ratio by increasing the dosegradient between target tissues and surrounding normal structures thereby offering probability of better loco-regional control with decreased risk of complications. IMRT is relatively intolerant to set-up uncertainties, warranting periodic image-guidance, making Image-Guided Radiation Therapy (IGRT) a natural corollary to IMRT. There are several challenges associated with the planning, delivery, and quality assurance of the IMRT and IGRT processes that must be addressed to realize the full potential of such exciting and promising technology. Given the complexities involved, it is quite intuitive to understand that IMRT and IGRT are resource-intensive, demanding increased labor, rigour, and expenses too. Other disadvantages associated with high-precision techniques include potentially increased risk of marginal failures, decreased dose homogeneity, and an increase in total body dose with increased risk of secondary carcinogenesis. The aim of this review is to define the role of IMRT and IGRT in contemporary head and neck oncologic practice through a critical appraisal of pertinent literature. Despite relatively short follow-up and limited clinical outcomes data, the weight of evidence suggests that loco-regional control is not inferior (either comparable or even better) and toxicity lesser with IMRT resulting in potentially improved quality-oflife, prompting the widespread adoption of such technology in community practice. Ongoing clinical trials in head and neck IMRT are currently addressing issues to optimize the IMRT process, adopting functional imaging for dose-painting, and incorporating adaptive re-planning strategies to further improve outcomes.

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Section: Current Best Evidencementioning

confidence: 67%

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Gupta

Agarwal

Susovan

et al. 2010

Indian J Surg Oncol

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“…Currently, a combined craniofacial approach that allows en bloc resection is usually performed, offering better local control and survival compared to a unique transfacial approach [3,10,25,30] . Standard radiotherapy dosage is between 55-65 Gy, preferably introduced with intensity modulated radiotherapy techniques, in order to minimize toxicity to adjacent structures [31] . Patients showing positive diagnosis of the lymph nodes have worse 5y-OS rate at 29% versus 64% for patients with no cervical lymph-node metastasis [3] .…”

Section: Discussionmentioning

confidence: 99%

Esthesioneuroblastoma: A case with prolonged disease control

et al. 2016

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Esthesioneuroblastoma, a rare tumor arising from the olfactory vault, varies from being indolent to extremely aggressive. Owing to its rarity, the diagnosis, staging, and treatment of the disease are not well defined. According to a number of small observational retrospective studies and case reports, the disease's actual treatment involves surgery, radiotherapy, and/or chemotherapy (either as a single treatment or used in combination), depending on the disease's staging. Optimal treatment has not been standardized, particularly regarding the role of chemotherapy. We describe a case of advanced esthesioneuroblastoma with prolonged disease control, subjected to a multimodal therapy with surgery, radiotherapy, and chemotherapy, illustrating the benefits of this approach in managing a patient with esthesioneuroblastoma. Herein, we analyze the most important and controversial issues of this type of neoplasia.Keywords: esthesioneuroblastoma; nasal cavity; surgery; radiotherapy; chemotherapy

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“…In the treatment of ENB, it is especially challenging to keep the radiation doses of the optic nerves and chiasm below the tolerance limits of these structures. In a recent publication by Madani et al, it was concluded that the low rates of late ocular toxicity demonstrate that IMRT could be considered the treatment of choice for sinonasal tumours [41].…”

Section: Discussionmentioning

confidence: 99%

The developing management of esthesioneuroblastoma: a single institution experience

Bäck

Oinas

Pietarinen-Runtti

et al. 2011

Eur Arch Otorhinolaryngol

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Esthesioneuroblastoma remains a challenging disease because of its rarity, the complexity of surrounding structures, missing opinions of optimal treatment protocol, and complications associated with necessary surgery. Our objective was to analyse the management and outcome of a cohort of patients with esthesioneuroblastoma from 1990 to 2009 in a tertiary medical centre. There were 17 eligible patients (8 males and 9 females) with the median age of 53 years (range 20-75 years). An obvious inconsistency was noted in the management of the various tumours of the present series during the two decades due to a lack of a uniform treatment protocol. The median follow-up time was 57.5 months (range 3-158 months). Nine patients (seven with curative treatment intent) died of the disease with the median time from diagnosis to death of 60 months (range 3-161 months). Eight patients had no evidence of the disease at last follow-up visit (median 76 months, range 24-119 months). Recurrences were documented in seven of the patients. The median time from end of primary treatment to a recurrence was 57 months (range 6-110 months). The 5-year overall survival and disease-free survival was 68 and 62%, respectively. The management of ENB should be planned by an experienced head and neck surgeon as part of a multidisciplinary team in a tertiary referral setting. Multimodality therapy with long-term follow-up is preferable and should be set based on the available disease-specific classifications for clinical staging and histopathological grading.

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Intensity-Modulated Radiotherapy for Sinonasal Tumors: Ghent University Hospital Update

Cited by 112 publications

References 25 publications

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Esthesioneuroblastoma: A case with prolonged disease control

The developing management of esthesioneuroblastoma: a single institution experience

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