Intensity modulated radiotherapy (IMRT) in patients with carcinomas of the paranasal sinuses: clinical benefit for complex shaped target volumes

Abstract

Introduction: The aim of the study was to evaluate the clinical outcome of intensity modulated radiotherapy (IMRT) in 46 patients with paranasal sinus tumors with special respect to treatment-related toxicity.

Intensity-Modulated Radiotherapy for Sinonasal Cancer: Improved Outcome Compared to Conventional Radiotherapy

“…In the IMRT group, local control at 2 years was 76%, and overall survival at 2 years was 89%, well within the range of earlier studies (27)(28)(29)(30)(31)(32)(33). Compared to the disease-free survival of the 3D-CRT group, a significant improvement in diseasefree survival was observed (60% vs. 72%; p = 0.02) for the IMRT group.…”

“…The resulting dosimetric advantage has been shown to translate into a clinical benefit, especially regarding organ-sparing (26). Results from several published studies of sinonasal cancer suggest that the use of IMRT reduces treatment-related toxicity, although it is not yet clear whether local control or survival is also improved (27)(28)(29)(30)(31)(32)(33). Obviously, the supreme conformality of IMRT theoretically increases the risk of a marginal miss, and without adequate compensation for setup uncertainties as well as appropriate selection and accurate delineation of target volumes, results with IMRT could very well be worse than before its wide-spread introduction (36).…”

“…Indeed, several reports have demonstrated that IMRT for SNC results in negligible acute or late toxicity while achieving promising tumor control rates (27)(28)(29)(30)(31)(32)(33). However, no comparison with conventional radiotherapy, regarding either tumor control or toxicity, is currently available.…”

Orbital carcinomas treated with adjuvant intensity‐modulated radiation therapy

“…Three‐dimensional conformal external beam radiotherapy allows for some improved tumor dose conformality but produces unacceptable plans for treatment of irregular targets close to critical structures. Compared to these traditional techniques, intensity‐modulated radiation therapy (IMRT) allows for conformal shaping of radiation doses to irregular tumor volumes and thus more effective doses delivered to the tumor with fewer adverse effects …”

Long‐term outcomes and toxicities of carbon‐ion radiotherapy in malignant tumors of the sphenoid sinus

“…15,16 In the present cohort, most of the patients presented with locally advanced disease with tumor invasion toward optic canal in 90.9% cases, tumor just touching or involving the optic nerve in 45.5% cases which was the most critical factor for higher risk of visual impairment, and it also made difficult to keep the D max of the optic pathway within the safest limit possible. 15,16 In the present cohort, most of the patients presented with locally advanced disease with tumor invasion toward optic canal in 90.9% cases, tumor just touching or involving the optic nerve in 45.5% cases which was the most critical factor for higher risk of visual impairment, and it also made difficult to keep the D max of the optic pathway within the safest limit possible.…”