How to Cite
Abstract
Local recurrence after primary radiotherapy (RT) of nasal cavity tumors occurs in 18-40% of patients within the first 5 years after treatment. The primary treatment for recurrence is surgery, but in situations where surgery for some reason is not possible, chemotherapy and/or radiotherapy can be used. Chemotherapy as the only treatment does not always produces satisfactory results, as the response to therapy occurs in less than 40% of cases and the median survival rate is less than one year. After high radiation doses in primary treatment surrounding healthy tissues have very low or almost no tolerance left. As a result, complication of radiation therapy can become more frequent and it can lead to worse treatment outcomes and a reduction in the quality of life of patients. The unique depth-dose distribution of proton therapy allows to minimize damage to healthy tissues. This could potentially reduce the number of early and late radiation complications and improve tolerability. This article describes our own experience of using proton therapy as a reirradiation technique in a patient with a recurrent nasal tumor that developed six years after the primary treatment. This example shows that proton therapy can be successfully applied as a retreatment option in patients with recurrent nasal cavity tumors, which is one of the most challenging sites for radiation treatment planning.
References
Cardesa A, Alos L, Nadal A, et al. Nasal Cavity and Paranasal Sinuses. Pathology of the Head and Neck. 2017:49-127. doi: 10.1007/978-3-662-49672-5_2.
Мудунов А.М., Чойнзонов Е.Л., Решетов И.В. и др. Рак ротоглотки: клинические рекомендации [Электронный ресурс]. Общероссийский национальный союз «Ассоциация онкологов России». Москва, 2020;62 [Mudunov AM, Choinzonov EL, Reshetov IV, et al. Clinical recommendations: Cancer of nasal cavity and paranasal sinuses. Association of Oncologists of Russia [Internet]. Moscow, 2020;62 (in Russ).]. Available from: https://old.oncology-association.ru/files/clinical-guidelines-2020/rak_rotoglotki.pdf.
Caudell JJ, Gillison ML, Maghami E, el al. NCCN Guidelines® insights: head and neck cancers, version 1.2022. J Natl Compr Canc Netw. 2022;20(3):224-234. doi:10.6004/JNCCN.2022.0016.
Kim SA, Chung YS, Lee BJ. Recurrence patterns of sinonasal cancers after a 5-year disease-free period. Laryngoscope. 2019;129(11):2451-2457. doi:10.1002/lary.27866.
Scurry WC Jr, Goldenberg D, Chee MY, et al. Regional recurrence of squamous cell carcinoma of the nasal cavity: a systematic review and meta-analysis. Arch Otolaryngol Head Neck Surg. 2007;133(8):796-800. doi:10.1001/archotol.133.8.796.
Wong SJ, Machtay M, Li Y. Locally recurrent, previously irradiated head and neck cancer: concurrent re-irradiation and chemotherapy, or chemotherapy alone? J.Clin.Oncol. 2006;24(17):2653–8. doi:10.1200/JCO.2005.05.3850.
Svajdova M, Dubinsky P, Kazda T. Radical external beam re-irradiation in the treatment of recurrent head and neck cancer: Critical review. Head Neck. 2021;43(1):354-366. doi:10.1002/hed.26485.
Kong L, Wang L, Shen C, et al. Salvage intensity-modulated radiation therapy (IMRT) for locally recurrent nasopharyngeal cancer after definitive IMRT: A Novel Scenario of the Modern Era. Sci Rep. 2016;6:32883. doi:10.1038/srep32883.
Yamazaki H, Ogita M, Kodani N, et al. Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study. Radiother. Oncol. 2013;107:305-309. doi:10.1016/j.radonc.2013.05.005.
Shuja M, Routman DM, Foote RL, et al. Clinical outcomes after re-irradiation in recurrent head and neck cancers treated with intensity modulated proton and photon therapies. Int J Radiat Oncol Biol Phys. 2019;105(1):E382-3. doi:10.1016/j.ijrobp.2019.06.1644.
Phan J, Sio TT, Nguyen TP, et al. Reirradiation of head and neck cancers with proton therapy: outcomes and analyses. Int J Radiat Oncol Biol Phys. 2016;96(1):30-41. doi:10.1016/j.ijrobp.2016.03.053.
McDonald MW, Zolali-Meybodi O, Lehnert SJ, et al. Reirradiation of recurrent and second primary head and neck cancer with proton therapy. Int J Radiat Oncol Biol Phys. 2016;96(4):808-819. doi:10.1016/j.ijrobp.2016.07.037.
Gordon K, Gulidov I, Semenov A, et al. Proton re-irradiation of unresectable recurrent head and neck cancers. Rep Pract Oncol Radiother. 2021 ;26(2):203-210. doi:10.21203/rs.3.rs-45989/v1.
Bentzen SM, Constine LS, Deasy JO, et al. Quantitative analyses of normal tissue effects in the clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys. 2010;76 (3):S3-9. doi:10.1016/j.ijrobp.2009.09.040.
Ang KK, Price RE, Stephens LC, et al. The tolerance of the primate spinal cord to re-irradiation. Int J Radiat Oncol Biol Phys. 1993;25(3):459-464. doi:10.1016/0360-3016(93)90067-6.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2023