Spot Scanning Proton Therapy for Sinonasal Malignant Tumors.
proton therapy
sinonasal cancer
spot scanning
Journal
International journal of particle therapy
ISSN: 2331-5180
Titre abrégé: Int J Part Ther
Pays: United States
ID NLM: 101674108
Informations de publication
Date de publication:
2021
2021
Historique:
received:
18
08
2020
accepted:
12
10
2020
entrez:
21
7
2021
pubmed:
22
7
2021
medline:
22
7
2021
Statut:
epublish
Résumé
Treatment of sinonasal malignant tumors is challenging, and evidence to establish a standard treatment is limited. Our objective was to evaluate the efficacy and safety of spot scanning proton therapy (SSPT) for sinonasal malignant tumors. We retrospectively analyzed patients with sinonasal malignant tumors (T1-4bN0-2M0) who underwent SSPT between May 2014 and September 2019. The prescription dose was typically either 60 GyRBE in 15 fractions or 60.8 GyRBE in 16 fractions for mucosal melanoma and 70.2 GyRBE in 26 fractions for other histologic subtypes. Endpoints included local control (LC), progression-free survival, overall survival (OS), and incidence of toxicity. Prognostic factors were analyzed using the Kaplan-Meier method and log-rank test. Of 62 enrolled patients, the common histologic subtypes were mucosal melanoma (35%), squamous cell carcinoma (27%), adenoid cystic carcinoma (16%), and olfactory neuroblastoma (10%). Locally advanced stages were common (T3 in 42% and T4 in 53%). Treatment-naïve tumors and postsurgical recurrent tumors accounted for 73% and 27%, respectively. No patient had previous radiotherapy. The median follow-up was 17 months (range, 6-66) for all patients and 21.5 months (range, 6-66) for survivors. The 2-year LC, progression-free survival, and OS rates of all patients were 92%, 50%, and 76%, respectively. Univariate analysis revealed histology as a prognostic factor for OS, being higher in adenoid cystic carcinoma and olfactory neuroblastoma than in other tumors. Sixteen grade ≥3 late toxicities were observed in 12 patients (19%), including 11 events resulting in visual impairment; the most common was cataract. There was 1 grade 4 toxicity, and there were no grade 5 toxicities. SSPT was well tolerated and yielded good LC for sinonasal malignant tumors. Although we consider SSPT to be a leading treatment modality, further studies are required to establish its status as a standard treatment.
Identifiants
pubmed: 34285946
doi: 10.14338/IJPT-D-20-00043.1
pii: Customer: THEIJPT-D-20-00043
pmc: PMC8270097
doi:
Types de publication
Journal Article
Langues
eng
Pagination
189-199Informations de copyright
©Copyright 2021 The Author(s).
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors have no relevant conflicts of interest to disclose.
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