Planned Gamma Knife Boost After Chemoradiotherapy for Selected Sinonasal and Nasopharyngeal Cancers.
World Neurosurg
; 119: e467-e474, 2018 Nov.
Article
em En
| MEDLINE
| ID: mdl-30071329
OBJECTIVE: To determine the feasibility of a Gamma Knife boost after intensity-modulated radiation therapy in combination with multimodal therapy in patients with nasopharyngeal carcinoma and sinonasal malignancies with skull base or cavernous sinus involvement. METHODS: Nine patients were treated with intensity-modulated radiation therapy followed by a Gamma Knife boost. In one case Gamma Knife was given as salvage treatment after resection. Five patients had sinonasal malignancies and 4 had nasopharyngeal carcinoma. The mean radiation therapy dose was 64.3 Gy (range, 54-70 Gy) at 2 Gy per fraction. The median interval from completion of radiation therapy to Gamma Knife boost was 2.2 months (range, 1-4 months). The most common indication for Gamma Knife boost was involvement of the cavernous sinus, which was identified in 7 patients. The median margin Gamma Knife dose delivered was 13 Gy (range, 12-20 Gy), with median prescription isodose of 50%. RESULTS: All patients tolerated the procedure well, with minimal toxicity. Local control rates were achieved in all patients and no acute grade 3-5 toxicity was observed. One patient experienced late grade 4 toxicity, which was potentially attributable to treatment. Distant failure occurred in 3 patients (1 patient with nasopharyngeal carcinoma and 2 patients with sinonasal malignancies). CONCLUSIONS: Planned Gamma Knife boost followed intensity-modulated radiation therapy is feasible, safe, and provides excellent local control in patients with sinonasal malignancies and nasopharyngeal carcinoma, particularly in cases with cavernous sinus involvement. Further follow-up will be necessary to determine the long-term effectiveness and complication profile.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias dos Seios Paranasais
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Neoplasias Nasofaríngeas
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Radiocirurgia
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Radioterapia de Intensidade Modulada
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Quimiorradioterapia
Tipo de estudo:
Observational_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World Neurosurg
Assunto da revista:
NEUROCIRURGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
Estados Unidos