Malignant tumors of the nasal cavity and paranasal sinuses

Purpose To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors. Materials and Methods Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or fron...

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Bibliographic Details
Published in:Head & neck 2002-09, Vol.24 (9), p.821-829
Main Authors: Katz, Teri S., Mendenhall, William M., Morris, Christopher G., Amdur, Robert J., Hinerman, Russell W., Villaret, Douglas B.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Blindness - etiology
Blindness - prevention & control
Carcinoma - mortality
Carcinoma - pathology
Carcinoma - therapy
Cause of Death
Chemotherapy, Adjuvant
Diseases of the upper aerodigestive tract
Ent and stomatology
Female
Humans
Male
Medical sciences
Middle Aged
Multivariate Analysis
nasal cavity
Nasal Cavity - pathology
Neoplasm Metastasis
Neoplasm Staging
nose neoplasms
Nose Neoplasms - mortality
Nose Neoplasms - pathology
Nose Neoplasms - therapy
Osteoradionecrosis - etiology
Otorhinolaryngology. Stomatology
paranasal sinus neoplasms
Paranasal Sinus Neoplasms - mortality
Paranasal Sinus Neoplasms - pathology
Paranasal Sinus Neoplasms - therapy
Postoperative Care
Preoperative Care
radiotherapy
Radiotherapy Dosage
Radiotherapy, Adjuvant - adverse effects
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Risk Factors
Survival Rate
Tumors
United States - epidemiology
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Purpose To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors. Materials and Methods Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or frontal sinus (1 patient) were treated with curative intent by radiation therapy alone or in the adjuvant setting. There were 25 squamous cell carcinomas, 14 undifferentiated carcinomas, 31 minor salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma), 8 esthesioneuroblastomas, and 1 transitional cell carcinoma. Forty‐seven patients were treated with irradiation alone, 25 with surgery and postoperative irradiation, 2 with preoperative irradiation and surgery, and 4 with chemotherapy in combination with irradiation with or without surgery. Results The 5‐year actuarial local control rate for stage I (limited to the site of origin; 22 patients) was 86%; for stage II (extension to adjacent sites (eg, adjacent sinuses, orbit, pterygomaxillary fossa, nasopharynx; 21 patients) was 65%; and for stage III (destruction of skull base or pterygoid plates, or intracranial extension; 35 patients) was 34%. The 5‐year actuarial local control rate for patients receiving postoperative irradiation was 79% and for patients receiving irradiation alone was 49% (p = .05). The 5‐, 10‐, 15‐, and 20‐year ultimate local control rates for all 78 patients were 60%, 56%, 48%, and 48%, respectively. The 5‐, 10‐, 15‐, and 20‐year cause‐specific survival rates for all 78 patients were 56%, 45%, 39%, and 39%, respectively. The 5‐, 10‐, 15‐, and 20‐year absolute survival rates for all 78 patients were 50%, 31%, 21%, and 16%, respectively. Of the 67 (86%) patients who were initially seen with node‐negative disease, 39 (58%) received no elective neck treatment, and 28 (42%) received elective neck irradiation. Of the 39 patients who received no elective neck treatment, 33 (85%) did not experience recurrence in the neck compared with 25 (89%) of 28 patients who received elective neck irradiation. Most patients who received elective neck irradiation (57%) had stage III disease. Twenty‐one (27%) of 78 patients had unilateral blindness develop secondary to radiation retinopathy or optic neuropathy; the complication was anticipated in most of these patients, because the ipsilateral eye was irradiated to a high dose. Four patients (5%) unexpectedly had bilateral blindnes
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.10143