Postoperative volumetric modulated arc therapy for sinonasal cancer: Improved survival compared with 3D conformal radiation therapy

Head Neck. 2019 Feb;41(2):448-455. doi: 10.1002/hed.25410. Epub 2018 Dec 14.

Abstract

Background: Prospective evaluation of the results of volumetric modulated arc therapy (VMAT) for sinonasal cancer compared to 3D conformal radiation therapy (3DCRT).

Materials and methods: We prospectively evaluated 34 patients (pts) treated with postoperative VMAT with simultaneous integrated boost (SIB; RapidArc) from 2011 to 2015. These pts were retrospectively compared with 24 pts treated with 3DCRT from 2003 to 2011. The two sets were not significantly different on sex, mean age, tumor site, stage, histology. Efficacy and toxicity were evaluated.

Results: Median follow-up was 45 months (range: 6-143 months). Three-year overall survival was 85.2% in VMAT-SIB versus 65.2% in 3DCRT (P = .02). Three-year local control was 81.2% in VMAT-SIB versus 62.5% in 3DCRT (P = .04). There was a reduction of acute (<0.09) and late (0.03) ocular toxicity of grade ≥ 2 for pts with VMAT-SIB.

Conclusion: VMAT significantly improved local control and overall survival in sinonasal cancer with lower rate of toxicity.

Keywords: VMAT; outcome; postoperative; radiation therapy; sinonasal cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / radiotherapy*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / radiotherapy*
  • Paranasal Sinus Neoplasms / surgery*
  • Radiotherapy, Adjuvant
  • Radiotherapy, Intensity-Modulated*
  • Survival Rate
  • Treatment Outcome