Post-operative intensity-modulated radiotherapy for malignancies of the nasal cavity and paranasal sinuses

Purpose: To evaluate the clinical outcome and toxicity of post-operative intensity-modulated radiotherapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses. Methods and materials: Twenty-five patients with histological proven cancer of the paranasal sinuses (n = 21) or nasal cavity (n = 4) were post-operatively treated with IMRT at the Leuven department to a total dose of 60 Gy (n = 15) or 66 Gy (n = 10). Both acute and chronic toxicity were prospectively scored in all patients. Results: Median follow-up was 27 months (range: 12-47 months) among surviving patients. The actuarial 2-year local control (LC), overall survival (OS) and disease-free survival (DFS) rates were 81%, 88% and 77%, respectively. One patient developed isolated distant metastasis, while none of the patients developed regional failure. No grade 3 or 4 toxicity was reported, either acute or chronic. No radiation-induced blindness or brain necrosis was reported to date, although longer follow-up has to be awaited for definitive results. Conclusion: Post-operative IMRT for sinonasal cancer resulted in similar local control and survival rates as conventional or 3D-conformal radiotherapy techniques, and was associated with little acute toxicity. Longer follow-up is necessary to confirm the lack of late complications. (c) 2007 Elsevier Ireland Ltd. All rights reserved.