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1.
Medicine (Baltimore) ; 100(35): e27136, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477164

RESUMO

RATIONALE: Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses is a rare but aggressive neoplasm with a poor prognosis and a strong propensity for regional recurrence and distant metastasis. Diagnosis is challenging and relies on immunohistochemical study. Treatment includes surgical resection, radiation therapy, chemotherapy, or a combination of these modalities. However, the optimal therapeutic strategy is still controversial. Due to its rarity, the complexity of the histological diagnosis, and the variety of the treatment regimens, we presented a case of primary small cell neuroendocrine carcinoma in the nasal cavity with description of the clinical manifestation, pathology features, and our treatment regimen. PATIENT CONCERNS: An 82-year-old female patient with hypertension presented with right epistaxis on and off with nasal obstruction for several days. DIAGNOSIS: An exophytic mass over the posterior end of the right inferior turbinate was found on nasopharyngoscope. Biopsy was done and the pathology confirmed small cell carcinoma, strongly positive for cytokeratin (AE1/AE3) and insulinoma-associated protein 1 (INSM-1), scatteredly positive for chromogranin A, synaptophysin and CD56. The final diagnosis was small cell neuroendocrine carcinoma of right nasal cavity, pT1N0M0, stage I. INTERVENTIONS: The patient underwent wide excision of right intra-nasal tumor and post-operative radiotherapy with a dose of 6600 cGy in 33 fractions. OUTCOMES: No local recurrence or distant metastasis was noted during the 12 months of follow-up. LESSONS: Multimodality treatment remains the most common therapeutic strategy, although no proven algorithm has been established due to the rarity of this disease. Further investigation is needed for providing evidence to standardize the treatment protocol.


Assuntos
Carcinoma Neuroendócrino/patologia , Cavidade Nasal/patologia , Neoplasias Nasais/patologia , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/radioterapia , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia
2.
Rhinology ; 59(5): 433-440, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34254061

RESUMO

BACKGROUND: There is no consensus about the optimal management of the neck in clinically node negative esthesioneuroblastoma (ENB). The aim of this study is to assess the impact of elective neck irradiation (ENI) in terms of regional disease control and survival. METHODS: The study was performed according to the PRISMA guidelines searching on Scopus, PubMed/MEDLINE, and Google Scholar databases. The primary outcome was the regional recurrence rate (RRR), that was reported as odds ratio (OR) and 95% confidence interval (CI). Secondary outcomes were the overall survival (OS), and the distant-metastases free survival (DMFS), that were reported as logarithm of the hazard ratios (logHRs) and 95% confidence intervals (CIs). RESULTS: A total of 489 clinically node negative patients were included from 9 retrospective studies. ENI significantly reduced the risk of regional recurrence compared to no treatment. No difference was measured between ENI and observation, according to both OS and DMFS. No stratified analysis could be performed based on Kadish stage and Hyams grade. CONCLUSIONS: ENI should be recommended to improve the regional disease control. No advantage was measured in terms of survival or distant metastases with a low quality of evidence. Further prospective studies should be designed to understand if ENI could be avoided in early stage and low-grade tumors.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Estesioneuroblastoma Olfatório/radioterapia , Humanos , Cavidade Nasal , Recidiva Local de Neoplasia , Neoplasias Nasais/radioterapia , Estudos Prospectivos , Estudos Retrospectivos
3.
J S Afr Vet Assoc ; 92(0): e1-e6, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34212735

RESUMO

Cutaneous squamous cell carcinoma (SCC) is a slow growing but locally invasive neoplasm, most commonly caused by prolonged exposure to ultraviolet (UV) radiation. Whilst SCC accounts for 15% of skin tumours in domesticated cats, cutaneous SCC in non-domesticated felids (apart from captive snow leopards) appears to be uncommon, with only three reports in the literature to date. In this report, a captive African lion (Panthera leo) presented with two ulcerative lesions on the nasal planum. Histopathology of the lesions revealed epidermal keratinocyte dysplasia and neoplastic basal- and supra-basal epithelial cells with dyskeratosis and evidence of basement membrane breaching and dermal invasion, consistent with a diagnosis of SCC. There was also evidence of laminar fibrosis and inflammation of the subjacent dermis suggesting that the SCC most likely resulted from UV-induced neoplastic transformation of the epidermal squamous epithelium following actinic keratosis. The lion was treated with hypofractionated radiation therapy and remained in remission until his death (euthanised 17 months later because of age-related chronic renal failure). This is the first report of cutaneous SCC in a lion with evidence of actinic damage and resolution after radiation therapy.


Assuntos
Carcinoma de Células Escamosas/veterinária , Leões , Neoplasias Nasais/veterinária , Hipofracionamento da Dose de Radiação , Neoplasias Cutâneas/veterinária , Animais , Carcinoma de Células Escamosas/radioterapia , Masculino , Neoplasias Nasais/radioterapia , Neoplasias Cutâneas/radioterapia
4.
Anticancer Res ; 41(5): 2495-2499, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33952477

RESUMO

BACKGROUND/AIM: Sino-nasal cancer is rare and often diagnosed at advanced stages. Some patients cannot receive curative treatment and are treated with palliative irradiation. We aimed to identify prognostic factors for survival to facilitate treatment personalization for this group. PATIENTS AND METHODS: Twelve patients treated with palliative radiotherapy for locally advanced sino-nasal cancer were retrospectively analyzed for survival. Ten characteristics were evaluated including age, gender, Karnofsky performance score (KPS), pre-radiotherapy hemoglobin, tumor site, lymph node involvement, histology, equivalent dose in 2 Gy-fractions, completion of radiotherapy and concurrent chemotherapy. RESULTS: On univariate analysis, KPS ≥70 (p<0.001) and completion of radiotherapy (p<0.001) were significantly associated with better survival. Chemotherapy showed a trend (p=0.097). In the multivariate analysis, KPS ≥70 was significant (p=0.025), and completion of radiotherapy showed a trend (p=0.080). CONCLUSION: KPS is an independent predictor of survival for palliative irradiation of sino-nasal cancer. Patients require close monitoring and care for side effects, since completion of radiotherapy is important for survival.


Assuntos
Neoplasias Nasais/radioterapia , Cuidados Paliativos/métodos , Radioterapia/métodos , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Neoplasias Nasais/patologia , Teste de Desfecho Sinonasal
5.
Head Neck ; 43(7): 2045-2057, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33687114

RESUMO

BACKGROUND: To assess the efficacy of intensity-modulated radiation therapy (IMRT) for tumors of the nasal cavity and paranasal sinus (PNS) region. MATERIALS AND METHODS: Two hundred fourteen patients with tumors of the nasal cavity and PNS region treated with curative intent IMRT between 2007 and 2019 were included in this retrospective analysis. RESULTS: Fifty-one (24.1%) received definitive RT/CTRT and 163 (75.9%) received adjuvant RT. Most common histology was squamous cell carcinoma (26.1%) followed by adenoid cystic carcinoma (21.5%). The median follow-up was 43.5 months. The 5-year local control (LC), event-free survival (EFS), and overall survival (OS) for the entire cohort was 66.9%, 59%, and 73.9%, respectively. On univariate analysis treatment with nonsurgical modality, T classification and undifferentiated/poorly differentiated histology were associated with inferior 5-year LC, EFS, and OS. Four patients had late Grade 3/Grade 4 ocular toxicity. CONCLUSIONS: IMRT should be the standard of care for tumors of PNS region across all histologies and treatment setting.


Assuntos
Neoplasias Nasais , Neoplasias dos Seios Paranasais , Radioterapia de Intensidade Modulada , Humanos , Cavidade Nasal , Neoplasias Nasais/radioterapia , Neoplasias dos Seios Paranasais/radioterapia , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/efeitos adversos , Estudos Retrospectivos
6.
Anticancer Res ; 41(3): 1587-1592, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33788753

RESUMO

BACKGROUND/AIM: Modern intensity-modulated radiotherapy (IMRT) is frequently applied to treat patients with nasal cavity and paranasal sinus (NC/PNS) malignancies. PATIENTS AND METHODS: One hundred and four patients who underwent radiotherapy (RT) between 1994 and 2020 were recognized. This analysis compared conventional-radiotherapy (CRT) and image-guided IMRT outcomes for NC/PNS malignancies. RESULTS: The median follow-up was 69 months. Eighty-eight patients (85%) were managed with image-guided IMRT. The median initial radiation dose was 65 Gy, with 68 Gy applied for patients treated with primary RT versus 63 Gy applied for adjuvant therapy (p=0.1). The 5-year locoregional control (LRC) was 85%. The locoregional recurrence rate was 18% following IMRT versus 31% in the 2D/3D-conventional RT group (p=0.09). Moreover, IMRT was associated with a lower inner-ear toxicity rate (8% vs. 20%, respectively; p=0.045). CONCLUSION: IMRT appears to be linked with higher LRC and lower inner-ear acute toxicities compared to conventional RT.


Assuntos
Cavidade Nasal , Neoplasias Nasais/radioterapia , Neoplasias dos Seios Paranasais/radioterapia , Radioterapia Guiada por Imagem/métodos , Radioterapia de Intensidade Modulada/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Dosagem Radioterapêutica , Radioterapia Guiada por Imagem/efeitos adversos , Radioterapia de Intensidade Modulada/efeitos adversos
7.
Vet Radiol Ultrasound ; 62(4): e40-e43, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33634903

RESUMO

A 6-year-old dog presented with a modified Adams stage 3 angiofibroma of the right nasal cavity, causing fluid accumulation along the right frontal sinus. Treatment consisted of step-and-shoot intensity-modulated radiation therapy in 12 daily treatments of 3.5 Gy, for a total dose of 42 Gy to 95% of the planning target volume. The dog developed self-limiting grade 2 oral mucositis which resolved within 2 weeks of course completion. A recheck exam 668 days after treatment confirmed a stable disease response by RECIST and a tumor volume decrease of 55.4%.


Assuntos
Angiofibroma/veterinária , Doenças do Cão/radioterapia , Neoplasias Nasais/veterinária , Radioterapia de Intensidade Modulada/veterinária , Angiofibroma/patologia , Angiofibroma/radioterapia , Animais , Doenças do Cão/patologia , Cães , Humanos , Masculino , Neoplasias Nasais/patologia , Neoplasias Nasais/radioterapia , Dosagem Radioterapêutica/veterinária , Planejamento da Radioterapia Assistida por Computador/veterinária , Resultado do Tratamento , Carga Tumoral
8.
J Vet Med Sci ; 83(3): 456-460, 2021 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-33473067

RESUMO

Nasal lymphoma (NL) is the most common nasal tumor in cats, and radiotherapy, chemotherapy, or a combination of these treatments have been described as the treatment for this disease. However, the previous studies included various machines and protocols of radiotherapy. Therefore, we aimed to retrospectively compare the prognosis among cases treated with palliative hypofractionated radiotherapy, chemotherapy, and a combination of them with united machine and protocol of radiotherapy. When compared overall survival and progression free survival, there was no significant difference among these three groups. The data of this study suggested that similar efficacy could be achieved by palliative hypofractionated radiotherapy, chemotherapy, or a combination of them.


Assuntos
Doenças do Gato , Linfoma , Neoplasias Nasais , Animais , Doenças do Gato/tratamento farmacológico , Doenças do Gato/radioterapia , Gatos , Linfoma/tratamento farmacológico , Linfoma/radioterapia , Linfoma/veterinária , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/radioterapia , Neoplasias Nasais/veterinária , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
9.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462035

RESUMO

Esthesioneuroblastoma (ENB) is an uncommon sinonasal cancer of the olfactory neuroepithelium that is typically treated with surgical resection followed by radiation therapy. Radiation-induced intracranial osteosarcoma of the skull base is a rare but devastating long-term complication of radiation therapy in this region. Here, we present a case of an 82-year-old patient who developed radiation-induced osteosarcoma of the anterior skull base and paranasal sinuses 10 years after radiation therapy following resection of an ENB. Older patients may be at risk of developing this complication earlier and with a worse prognosis relative to younger patients. Treating physicians/surgeons should be aware of this devastating complication. Patients who are treated with high-dose radiation therapy in this region should be followed for many years.


Assuntos
Estesioneuroblastoma Olfatório/radioterapia , Cavidade Nasal , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Nasais/radioterapia , Osteossarcoma/etiologia , Neoplasias da Base do Crânio/etiologia , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Induzidas por Radiação/diagnóstico , Osteossarcoma/diagnóstico , Neoplasias da Base do Crânio/diagnóstico
10.
Hematology ; 26(1): 75-82, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33427594

RESUMO

OBJECTIVE: To assess clinical outcomes of newly diagnosed extranodal NK/T-cell lymphoma nasal-type (ENKTL) patients treated with L-asparaginase-containing chemotherapy as first-line chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed data of new ENKTL patients in Siriraj Hospital, Thailand during 2012-2016. RESULTS: Among 27 patients, 16 were men and 11 were women, and their median age was 52 (range, 25-83) years. The primary sites were the aero-nasal area (23) and skin (4). Clinical stages of ENKTL were I, II, III and IV in 10, 8, 1 and 8 patients, respectively. Patients classified according to the NK cell-lymphoma prognostic index with PINK (27) and PINK-E (19) as low, intermediate, and high were 14, 8, 5, respectively and 11, 4, and 4, respectively. Chemotherapy regimens used were SMILE (24) and AspaMetDex (3). Fourteen patients received post- chemotherapy local radiation. The overall response rate for 26 assessable patients was 69%, with complete response in 14 patients (52%). Median progression-free and overall survival were 32 and 33 months, respectively. The most common L-asparaginase regimen related complications were hypofibrinogenemia (24) and hypersensitivity (9). The overall mortality at follow-up was 14/27 (52%) owing to sepsis (11) and disease progression (3). DISCUSSION: L-asparaginase-based regimens showed similar results as other study results. including those in which hematopoietic stem cell transplantation was performed, suggesting that transplantation can be avoided if it is unaffordable. Thrombosis or bleeding, the regimen side effects, should be carefully monitored during treatment. CONCLUSIONS: L-asparaginase-based regimens offer a good outcome as a front-line treatment for ENKTL.


Assuntos
Antineoplásicos/uso terapêutico , Asparaginase/uso terapêutico , Linfoma Extranodal de Células T-NK/tratamento farmacológico , Neoplasias Nasais/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Asparaginase/efeitos adversos , Feminino , Humanos , Linfoma Extranodal de Células T-NK/diagnóstico , Linfoma Extranodal de Células T-NK/epidemiologia , Linfoma Extranodal de Células T-NK/radioterapia , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/epidemiologia , Neoplasias Nasais/radioterapia , Prognóstico , Estudos Retrospectivos , Tailândia/epidemiologia , Resultado do Tratamento
11.
Clin Nucl Med ; 46(2): e123-e124, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33156054

RESUMO

ABSTRACT: Prostate-specific membrane antigen (PSMA) is universally expressed in the endothelial cells of tumor-associated neovasculature of juvenile nasopharyngeal angiofibroma. Functional 68Ga-PSMA PET/CT also enables easier differentiation of the residual tumor from postoperative changes. An 18-year-old man with the residual intracranial disease received radiotherapy after surgery. In PSMA PET/CT imaging, uptake was noted initially only in the residual disease, and the same was absent after successful response to radiotherapy, unlike contrast MRI, which showed persistent enhancement. Functional 68Ga-PSMA PET/CT may be a very useful tool clinically for identifying early responses to radiotherapy compared with conventional structural imaging.


Assuntos
Angiofibroma/diagnóstico por imagem , Angiofibroma/radioterapia , Glicoproteínas de Membrana , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/radioterapia , Compostos Organometálicos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adolescente , Humanos , Imageamento por Ressonância Magnética , Masculino , Resultado do Tratamento
12.
Laryngoscope ; 131(4): E1198-E1208, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33006408

RESUMO

OBJECTIVES: Squamous cell carcinoma of nasal vestibule and pyramid is rare, thus classification, treatment protocol, and indications for elective neck treatment are still controversial. Nasal reconstruction is challenging, as well, and prosthesis is still used. STUDY DESIGN: Retrospective cohort study. METHODS: Retrospective review of patients surgically treated from 2010 to 2018 in a single Institution. Advanced tumors were further treated with adjuvant irradiation. Reconstruction strategy included grafts, locoregional and free flaps, and was customized on layers removed. RESULTS: Forty-five patients were enrolled. The 5-year overall survival and disease-free survival were 81.9% ± 7.45% and 61.9% ± 9.09%, respectively. Wang's classification, site of origin, extent of surgery and margins status significantly correlated with prognosis and recurrence rate. Regional recurrences occurred in patients affected by advanced tumors who did not receive any form of elective neck treatment. CONCLUSION: Multidisciplinary management and a proper reconstructive algorithm are recommended. Adjuvant irradiation and elective neck treatment should be advocated for advanced stage high-risk patients. LEVEL OF EVIDENCE: 4. Laryngoscope, 131:E1198-E1208, 2021.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Nasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/radioterapia , Feminino , Retalhos de Tecido Biológico , Humanos , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Recidiva Local de Neoplasia , Neoplasias Nasais/mortalidade , Neoplasias Nasais/radioterapia , Prognóstico , Próteses e Implantes , Radioterapia Adjuvante , Estudos Retrospectivos , Taxa de Sobrevida
13.
J Cancer Res Ther ; 16(Supplement): S213-S216, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33380681

RESUMO

Neovascular glaucoma (NVG) is a potentially blinding form of secondary glaucoma, with radiation being one of the rare causes. This report is aimed to discuss a case of NVG caused secondary to radiotherapy (RT) given for a nasal malignancy. A 50-year-old male presented with enophthalmos, dry eye, and NVG 3 years after receiving RT for chondrosarcoma of nasal and paranasal cavities. He was given topical antiglaucoma medications, retinal laser, and intravitreal bevacizumab injection and thus prevented the eye from becoming a painful blind eye. The radiation oncologist and ear, nose, and throat specialists have to liaise closely with ophthalmologist when patients receive radiation involving the eye in the treatment field to prevent, diagnose, and treat this devastating condition.


Assuntos
Neoplasias Ósseas/radioterapia , Condrossarcoma/radioterapia , Glaucoma Neovascular/patologia , Neoplasias Nasais/radioterapia , Neoplasias dos Seios Paranasais/radioterapia , Radioterapia/efeitos adversos , Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Glaucoma Neovascular/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/patologia , Neoplasias dos Seios Paranasais/patologia , Prognóstico
14.
J Radiat Res ; 61(6): 920-928, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32960262

RESUMO

The aim of the study was to evaluate the clinical feasibility of a 3D-print silica bolus for nasal NK/T-cell lymphoma radiation therapy. Intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) plans were designed using an anthropomorphic head phantom with a 3D-print silica bolus and other kinds of bolus used clinically, and the surface dose was measured by a metal oxide semiconductor field-effect transistor (MOSFET) dosimeter. Four nasal NK/T patients with or without 3D-print silica bolus were treated and the nose surface dose was measured using a MOSFET dosimeter during the first treatment. Plans for the anthropomorphic head phantom with 3D-print bolus have more uniform dose and higher conformity of the planning target volume (PTV) compared to other boluses; the homogeneity index (HI) and conformity index (CI) of the VMAT plan were 0.0589 and 0.7022, respectively, and the HI and CI of the IMRT plan were 0.0550 and 0.7324, respectively. The MOSFET measurement results showed that the surface dose of the phantom with 3D-print bolus was >180 cGy, and that of patients with 3D-print bolus was higher than patients without bolus. The air gap volume between the 3D-print bolus and the surface of patients was <0.3 cc. The 3D-print silica bolus fitted well on the patient's skin, effectively reducing air gaps between bolus and patient surface. Meanwhile, the 3D-print silica bolus provided patients with higher individuation, and improved the conformity and uniformity of the PTV compared to other kinds of boluses.


Assuntos
Linfoma Extranodal de Células T-NK/radioterapia , Neoplasias Nasais/radioterapia , Impressão Tridimensional , Radioterapia de Intensidade Modulada/métodos , Radioterapia/instrumentação , Dióxido de Silício/química , Antropometria , Humanos , Órgãos em Risco/efeitos da radiação , Imagens de Fantasmas , Fótons , Radiometria , Radioterapia/métodos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Fluxo de Trabalho
15.
Cancer Sci ; 111(12): 4465-4479, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32936975

RESUMO

The aim of this study is to compare the effectiveness of carbon ion radiation therapy (CIRT), proton radiation therapy (PRT), and photon-based intensity-modulated radiation therapy (IMRT) in the treatment of sinonasal malignancies. We identified studies through systematic review and divided them into three cohorts (CIRT group/PRT group/IMRT group). Primary outcomes of interest were overall survival (OS) and local control (LC). We pooled the outcomes with meta-analysis and compared the survival difference among groups using Chi2 (χ2 ) test. A representative sample of 2282 patients with sinonasal malignancies (911 in the CIRT group, 599 in the PRT group, and 772 in the IMRT group) from 44 observation studies (7 CIRT, 16 PRT, and 21 IMRT) was included. The pooled 3-year OS, LC, distant metastasis-free survival, and progression-free survival rates were 67.0%, 72.8%, 69.4%, and 52.8%, respectively. Through cross-group analysis, the OS was significantly higher after CIRT (75.1%, 95% CI: 67.1%-83.2%) than PRT (66.2%, 95% CI: 57.7%-74.6%; χ2  = 13.374, P < .0001) or IMRT (63.8%, 95% CI: 55.3%-72.3%; χ2  = 23.814, P < .0001). LC was significantly higher after CIRT (80.2%, 95% CI: 73.9%-86.5%) than PRT (72.9%, 95% CI: 63.7%-82.0%; χ2  = 8.955, P = .003) or IMRT (67.8%, 95% CI: 59.4%-76.2%; χ2  = 30.955, P < .0001). However, no significant difference between PRT and IMRT for OS and LC was observed. CIRT appeared to provide better OS and LC for patients with malignancies of nasal cavity and paranasal sinuses. A prospective randomized clinical trial is needed to confirm the superiority of CIRT in the treatment of sinonasal tumors.


Assuntos
Radioterapia com Íons Pesados , Neoplasias Nasais/radioterapia , Neoplasias dos Seios Paranasais/radioterapia , Terapia com Prótons , Radioterapia de Intensidade Modulada/métodos , Distribuição de Qui-Quadrado , Feminino , Radioterapia com Íons Pesados/efeitos adversos , Radioterapia com Íons Pesados/mortalidade , Radioterapia com Íons Pesados/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/mortalidade , Neoplasias dos Seios Paranasais/mortalidade , Intervalo Livre de Progressão , Terapia com Prótons/efeitos adversos , Terapia com Prótons/mortalidade , Terapia com Prótons/estatística & dados numéricos , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/mortalidade , Radioterapia de Intensidade Modulada/estatística & dados numéricos
16.
Cancer Med ; 9(21): 7914-7924, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32977357

RESUMO

BACKGROUND: Sinonasal malignancies (SNM) include malignant neoplasms of various histologies that originate from the paranasal sinuses or nasal cavity. This study reported the safety and efficacy of particle-beam radiation therapy (PBRT) for the treatment of sinonasal malignancies. METHODS AND MATERIALS: One-hundred-and-eleven patients with nonmetastatic sinonasal malignancies received definitive (82.9%) or salvage (31.5%) PBRT. The majority (85.6%) of patients presented with T3/4 disease, and only 19 (17.1%) had R0 or R1 resection. Seventy (63.1%) patients received carbon-ion radiotherapy (CIRT), 37 received proton radiotherapy (PRT) followed by CIRT boost, and 4 received PRT alone. Prognostic factors were analyzed using Cox regression for univariate and multiple regression. Toxicities were reported using the Common Terminology Criteria for Adverse Events (version 4.03). RESULTS: The median follow-up was 20.2 months for the entire cohort. The 2-year local progression-free survival (LPFS), regional progression-free survival (RPFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 83%, 97.2%, 85.9%, 66%, and 82%, respectively. Re-irradiation and large GTV were the significant factors for OS. Melanoma and sarcoma patients had significantly higher distant metastatic rate, and poorer OS and PFS. Late toxicity occurred in 22 (19.8%) patients, but only 4 (3.6%) patients experienced grades 3-4 late toxicity. CONCLUSIONS: Particle-beam radiation therapy results in excellent local-regional control with extremely low serve toxicities for patients with SNM. Sarcoma and melanoma were featured with a greater risk of death from distant dissemination. Patients who underwent re-irradiation had significantly worse OS. PBRT is feasible and safe in the management of SNM.


Assuntos
Radioterapia com Íons Pesados , Neoplasias Nasais/radioterapia , Neoplasias dos Seios Paranasais/radioterapia , Terapia com Prótons , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Institutos de Câncer , China , Progressão da Doença , Feminino , Radioterapia com Íons Pesados/efeitos adversos , Radioterapia com Íons Pesados/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/mortalidade , Neoplasias Nasais/patologia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Intervalo Livre de Progressão , Terapia com Prótons/efeitos adversos , Terapia com Prótons/mortalidade , Doses de Radiação , Reirradiação , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
17.
Adv Otorhinolaryngol ; 84: 137-153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731230

RESUMO

This review of sinonasal adenocarcinoma, both intestinal and non-intestinal type, aims at providing a comprehensive overview of etiological factors, diagnostic workup, histological subtypes, advances in molecular characterization and the genetic basis, current optimal treatment strategies, resulting oncological outcome, and prognostic factors modifying the final treatment results. The current treatment of choice remains surgical resection with a curative intent, using the least invasive approach that allows for removal of the entire tumor with negative margins, supplemented with postoperative high-quality intensity-modulated radiotherapy in the majority of patients. To date, chemotherapy remains reserved for the palliative setting. The progress in understanding the underlying molecular biological mechanisms has not yet translated into standard of care applications.


Assuntos
Adenocarcinoma , Neoplasias Nasais , Neoplasias dos Seios Paranasais , Adenocarcinoma/diagnóstico , Adenocarcinoma/epidemiologia , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Terapia Combinada , Tratamento Farmacológico , Humanos , Recidiva Local de Neoplasia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/epidemiologia , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/radioterapia , Neoplasias dos Seios Paranasais/cirurgia , Prognóstico
18.
Anticancer Drugs ; 31(7): 751-753, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32697469

RESUMO

Cutaneous squamous cell carcinoma of the head and neck district are generally treated with surgery. Surgery is the standard treatment in early stages and local advanced tumors, followed by adjuvant therapy, radiation or concurrent chemoradiation therapy. Local recurrence treatment depends on previous therapies, though radical surgery is often the first choice at the expense of anatomy preservation. We present the case of a patient with cutaneous squamous cell carcinoma of the nasal dorsum which relapsed after surgery and radiation therapy. The patient refused radical surgery and electrochemotherapy under general anesthesia was administered. After 6 months from treatment, the patient showed a complete clinical response. Electrochemotherapy could be considered as an alternative to surgery in small lesion when other approaches are refused.


Assuntos
Eletroquimioterapia/métodos , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Nasais/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Idoso de 80 Anos ou mais , Bleomicina/administração & dosagem , Feminino , Humanos , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Radioterapia Adjuvante , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia
19.
Vet Radiol Ultrasound ; 61(6): 718-725, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32713101

RESUMO

Dogs with sinonasal tumors with cribriform plate lysis (modified Adams' stage 4) treated with non-conformal definitive radiotherapy (RT) have short median survivals of 6-7 months. Intensity-modulated radiotherapy with its greater conformality and tumor dose homogeneity may result in more favorable outcomes. Dogs with epithelial or mesenchymal sinonasal tumors and CT evidence of cribriform lysis that received 10 daily fractions of 4.2 Gray using IMRT by helical tomotherapy were included in this single-institution retrospective case series study. Dogs with distant metastasis, previous treatment, or concurrent chemotherapy were excluded. Based on CT, tumors were divided into two groups: cribriform plate lysis only (stage 4a) or intracranial extension (stage 4b). Twenty-nine dogs were included, 23 with carcinoma and six with sarcoma. Eight dogs had stage 4b tumors; two presented with neurologic signs. Two dogs had lymph node metastasis at diagnosis, one confirmed and one suspected. Radiation dose distributions were standardized and patient positioning for RT was verified daily using on-board megavoltage CT. All evaluable dogs had improvement of clinical signs. Median progression free survival was 177 days (95% CI, 128-294 days). Median overall survival was 319 days (95% CI, 188-499 days). Radiotherapy was well tolerated. The most common side effect was grade 1 or 2 oral mucositis. Two dogs that received additional treatment at progression (stereotactic RT [1]; surgery [1]) developed significant late effects. Image-guided definitive-intent IMRT may improve survival in dogs with modified Adams' stage 4 sinonasal tumors and is associated with low morbidity. Intracranial tumor extension was not prognostic in this cohort of uniformly treated dogs.


Assuntos
Doenças do Cão/radioterapia , Neoplasias Nasais/veterinária , Seios Paranasais , Sarcoma/veterinária , Animais , Intervalo Livre de Doença , Doenças do Cão/mortalidade , Cães , Feminino , Metástase Linfática , Masculino , Neoplasias Nasais/patologia , Neoplasias Nasais/radioterapia , Planejamento da Radioterapia Assistida por Computador/veterinária , Radioterapia de Intensidade Modulada/veterinária , Registros/veterinária , Estudos Retrospectivos , Sarcoma/radioterapia , Sarcoma/secundário
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