Radiooncological View on Therapy Outcome after Multidisciplinary Treatment of Sinonasal Tumors.

Olena Klymenko,Anja Pickhard,Steffi U Pigorsch,Barbara Wollenberg,Anna Maria Stefanie Buchberger,Stephanie E Combs,Victoria Kehl,Klaus-Dietrich Wolff

doi:10.3390/cancers13102364

Olena Klymenko, Anja Pickhard + Show 6 more

Open Access

https://doi.org/10.3390/cancers13102364

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Abstract

We report the outcome of a mono-institutional retrospective study of sinonasal carcinoma with the primary focus on GTV (gross tumor volume) and the effect of radiotherapy. 53 patients with sinonasal carcinoma and that of the nasal cavity, paranasal sinus or both except lymphoma were included. All patients were treated between 1999 and 2017. For tumor volume delineation, all pre-therapeutic images were fused to the planning CT (computed tomography). The median follow-up was 17 months [0.3-60], the median age 60 years, 35 males and 18 females were included. Squamous cell carcinoma (SCC) (60.4%) was the predominant histology, followed by adenocarcinoma (15.1%). The mean composite OS (overall survival) time was 33.3 ± 3.5 months. There was no significant difference in the 5 y composite OS between tumor localization or radiotherapy setting. The simultaneous integrated boost concept showed a trend towards improving five-year composite OS compared to the sequential boost concept. The only factor with a significant impact on the 5 y composite OS rate was the pre-therapeutic GTV (cutoff 75 cm3; p = 0.033). The GTV ≥ 100 cm3 has no effect on the 5 y composite OS rate for SCC. The pre-therapeutic GTV is a prognostic factor for five-year composite OS for the entire group of patients with sinonasal tumors, influencing the outcome after completion of all treatment strategies. The GTV seems to not influence five-year composite OS in SCC. For this rare tumor entity, an intensive, multidisciplinary discussion is essential to finding the best treatment option for the patient.

Highlights

Sinonasal malignancies are very rare tumors, with an incidence of approximately 0.6 per 100,000 people
Since 2008, 49 out of 53 patients have been treated with intensity-modulated radiotherapy (IMRT) either delivered by LINAC (n = 18) or by helical tomotherapy (HT) (n = 31)
We clearly show that initial gross tumor volume (GTV) is a prognostic factor for the five-year composite OS in sinonasal carcinoma, as shown by other investigators

Summary

Introduction

Sinonasal malignancies are very rare tumors, with an incidence of approximately 0.6 per 100,000 people. Approximately 3% of all head and neck tumors are located in the paranasal sinuses or nasal cavity [1,2] and comprise only 0.2–0.3% of all cancers [3]. They are more common among males [2,4] and are most frequently found in the maxillary sinus and nasal cavity [2]. The prognosis of patients with sinonasal carcinomas, despite progress in therapy modalities and regimes, remains poor. The median OS time is given with 27.6–98.6 months [6,7,8,9]

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