Abstract
Objectives: In very advance unresectable stages Juvenile nasopharyngeal angiofibroma (JNA)radiotherapy is treatment of choice. Usually JNA is in close proximity to different organ at risk, which necessitates accurate and precise radiation delivery. Series reported the application of IMRT (Intensity Modulated Radiotherapy) with good sparing of organ at risk, but the literature search found no report on VMAT (Volumetric Modulated Arc Therapy) treatment in case of JNA. Clinical case: The present publication report for first time a patient irradiated with VMAT and IGRT (Image guided radiotherapy) for JNA. The stage of the tumor based on CT and MRI was IIIB according to Radkovsi with cavernous sinus invasion. Moderate total radiation dose 36 Gy in 1.8 Gy per fraction was delivered. No early and late toxicity was recorded. The patient is followed up every six months and persistent residual tumor on MRI was seen, but no bleeding onphysical exam. At one year follow up this is accepted as good local control. Conclusion: VMAT and IGRT could be safely applied with reduction of the radiation dose at organ of risk. VMAT is promising in the treatment of juvenile angiofibroma with advantages over conventional radiotherapy, but as this is case report of only one patient, further experience with VMAT is needed in JNA
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