Proton beam therapy for locally advanced and unresectable (T4bN0M0) squamous cell carcinoma of the ethmoid sinus: A report of seven cases and a literature review

Saito,Takashi; Ishikawa,Hitoshi; Ohnishi,Kayoko; Aihara,Teruhito; Mizumoto,Masashi; Fukumitsu,Nobuyoshi; Sugawara,Kaori; Okumura,Toshiyuki; Sakurai,Hideyuki

doi:10.3892/ol.2015.3214

Proton beam therapy for locally advanced and unresectable (T4bN0M0) squamous cell carcinoma of the ethmoid sinus: A report of seven cases and a literature review

Authors:
- Takashi Saito
- Hitoshi Ishikawa
- Kayoko Ohnishi
- Teruhito Aihara
- Masashi Mizumoto
- Nobuyoshi Fukumitsu
- Kaori Sugawara
- Toshiyuki Okumura
- Hideyuki Sakurai
View Affiliations

Affiliations: Department of Radiation Oncology, University of Tsukuba, Faculty of Medicine, Tsukuba, Ibaraki 305‑8575, Japan
Published online on: May 15, 2015 https://doi.org/10.3892/ol.2015.3214
Pages: 201-205
Copyright: © Saito et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The present study reports treatment outcomes of locally advanced and unresectable squamous cell carcinoma of the ethmoid sinus (SCC-ES) following proton beam therapy (PBT). Between January 1997 and December 2012, 7 patients (median age, 63 years) with SCC‑ES underwent definitive PBT. All tumors were categorized as T4bN0M0 (2009 UICC tumor‑node‑metastasis classification) and were treated using conventional fractionation at a median total dose of 72 Gy equivalents (GyE; range, 70.4‑76 GyE). Imaging diagnosis for the initial treatment effect within 3 months of PBT revealed that a complete response (CR) was achieved in 2 patients and a partial response (PR) in 5 patients. The overall median survival time of the patients was 43 months (range, 12‑62 months), and 4 patients survived for ≥3 years. No recurrence was observed in the 2 patients who exhibited an initial CR treatment effect; however, locoregional recurrences occurred in 4/5 patients who exhibited a PR. No grade 3 or severe acute toxicities were observed, but the late toxicities of grade 3 contralateral optic nerve damage and cataracts developed in 1 and 2 patients, respectively. Based on the findings of the present study, intensification of the local treatment effect may be important for yielding favorable treatment outcomes, since no distant metastasis was observed. PBT is therefore a potentially useful treatment tool for unresectable SCC-ES.

View Figures

View References

1	Blanco AI, Chao KS, Ozyigit G, et al: Carcinoma of paranasal sinuses: Long-term outcomes with radiotherapy. Int J Radiat Oncol Biol Phys. 59:51–58. 2004. View Article : Google Scholar : PubMed/NCBI
2	Jansen EP, Keus RB, Hilgers FJ, et al: Does the combination of radiotherapy and debulking surgery favor survival in paranasal sinus carcinoma? Int J Radiat Oncol Biol Phys. 48:27–35. 2000. View Article : Google Scholar : PubMed/NCBI
3	Dulguerov P, Jacobsen MS, Allal AS, Lehmann W and Calcaterra T: Nasal and paranasal sinus carcinoma: Are we making progress? a series of 220 patients and a systematic review. Cancer. 92:3012–3029. 2001. View Article : Google Scholar : PubMed/NCBI
4	Jiang GL, Morrison WH, Garden AS, et al: Ethmoid sinus carcinomas: Natural history and treatment results. Radiother Oncol. 49:21–27. 1998. View Article : Google Scholar : PubMed/NCBI
5	Waldron JN, O'Sullivan B, Warde P, et al: Ethmoid sinus cancer: Twenty-nine cases managed with primary radiation therapy. Int J Radiat Oncol Biol Phys. 41:361–369. 1998. View Article : Google Scholar : PubMed/NCBI
6	Lomax AJ, Goitein M, Adams J, et al: Intensity modulation in radiotherapy: Photons versus protons in the paranasal sinus. Radiother Oncol. 66:11–18. 2003. View Article : Google Scholar : PubMed/NCBI
7	Hojo H, Zenda S, Akimoto T, et al: Impact of early radiological response evaluation on radiotherapeutic outcomes in the patients with nasal cavity and paranasal sinus malignancies. J Radiat Res. 53:704–709. 2012. View Article : Google Scholar : PubMed/NCBI
8	Truong MT, Kamat UR, Liebsch NJ, et al: Proton radiation therapy for primary sphenoid sinus malignancies: Treatment outcome and prognostic factors. Head Neck. 31:1297–1308. 2009. View Article : Google Scholar : PubMed/NCBI
9	Pommier P, Liebsch NJ, Deschler DG, et al: Proton beam radiation therapy for skull base adenoid cystic carcinoma. Arch Otolaryngol Head Neck Surg. 132:1242–1249. 2006. View Article : Google Scholar : PubMed/NCBI
10	Zenda S, Kohno R, Kawashima M, et al: Proton beam therapy for unresectable malignancies of the nasal cavity and paranasal sinuses. Int J Radiat Oncol Biol Phys. 81:1473–1478. 2011. View Article : Google Scholar : PubMed/NCBI
11	Suit H and Urie M: Proton beams in radiation therapy. J Nat Cancer Inst. 84:155–164. 1992. View Article : Google Scholar : PubMed/NCBI
12	Sobin LH, Wittekind C and Gospodarowicz M: Nasal cavity and paranasal sinuses. TNM Classification of Malignant Tumors. 7th. Wiley-Blackwell; New York, NY: pp. 46–50. 2009
13	Fukumitsu N, Okumura T, Mizumoto M, et al: Outcome of T4 (International Union Against Cancer Staging System, 7th edition) or recurrent nasal cavity and paranasal sinus carcinoma treated with proton beam. Int J Radiat Oncol Biol Phys. 83:704–711. 2012. View Article : Google Scholar : PubMed/NCBI
14	Therasse P, Arbuck SG, Eisenhauer EA, et al: New guidelines to evaluate the response to treatment in solid tumors. European organization for research and treatment of cancer, national cancer institute of the United States, national cancer institute of Canada. J Natl Cancer Inst. 92:205–216. 2000. View Article : Google Scholar : PubMed/NCBI
15	National Cancer Institute, . Common Terminology Criteria for Adverse Events (CTCAE) v4.0 2010. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5′7.pdfAccessed. April 24–2014
16	Hoppe BS, Nelson CJ, Gomez DR, et al: Unresectable carcinoma of the paranasal sinuses: Outcomes and toxicities. Int J Radiat Oncol Biol Phys. 72:763–769. 2008. View Article : Google Scholar : PubMed/NCBI
17	Padovani L, Pommier P, Clippe SS, et al: Three-dimensional conformal radiotherapy for paranasal sinus carcinoma: Clinical results for 25 patients. Int J Radiat Oncol Biol Phys. 56:169–176. 2003. View Article : Google Scholar : PubMed/NCBI
18	Mock U, Georg D, Bogner J, Auberger T and Pötter R: Treatment planning comparison of conventional, 3d conformal and intensity-modulated photon (IMRT) and proton therapy for paranasal sinus carcinoma. Int J Radiat Oncol Biol Phys. 58:147–154. 2004. View Article : Google Scholar : PubMed/NCBI
19	Kandula S, Zhu X, Garden AS, et al: Spot-scanning beam proton therapy vs intensity-modulated radiation therapy for ipsilateral head and neck malignancies: A treatment planning comparison. Med Dosim. 38:390–394. 2013. View Article : Google Scholar : PubMed/NCBI
20	Flynn RT, Bowen SR, Bentzen SM, Rockwell Mackie T and Jeraj R: Intensity-modulated x-ray (IMXT) versus proton (IMPT) therapy for theragnostic hypoxia-based dose painting. Phys Med Biol. 53:4153–4167. 2008. View Article : Google Scholar : PubMed/NCBI