Proton Therapy for Maxillary Sinus Carcinoma

Department of Radiation Oncology, University of Florida, Jacksonville, FL, USA.
American journal of clinical oncology (Impact Factor: 3.06). 06/2009; 32(3):296-303. DOI: 10.1097/COC.0b013e318187132a
Source: PubMed


To compare the dose-volume data of three-dimensional conformal proton therapy (3DCPT) versus intensity-modulated radiotherapy (IMRT) for a paranasal sinus malignancy.
3DCPT and IMRT plans were created for a T4N0 maxillary sinus carcinoma.
The target volume dose distributions were comparable for 3DCPT and IMRT. The mean and integral doses for all normal tissues were lower for 3DCPT. The maximum doses for both plans to the ipsilateral optic nerve/retina/lens, temporal lobe, pituitary, and brain exceeded tolerance doses. The contralateral parotid, lacrimal gland, and lens were avoided with 3DCPT. Neither 3DCPT nor IMRT exceeded the maximal tolerated dose for the brainstem, optic chiasm, contralateral temporal lobe, parotid, or lacrimal gland.
Both 3DCPT and IMRT sufficiently covered the target volume(s). Although 3DCPT reduced the mean and integral dose to all of the normal tissues, both 3DCPT and IMRT irradiated the ipsilateral optic structures beyond acceptable tolerance doses.

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    • "Again, several dosimetric studies have been performed evaluating proton therapy, for the most part 3D-CPT, compared to IMRT. These support the ability of proton therapy to result in sparing of normal tissue when radiation is required to the paranasal sinuses (Miralbell et al., 1992; Mock et al., 2004; Chera et al., 2009), nasopharynx (Brown et al., 1989; Taheri-Kadkhoda et al., 2008; Widescott et al., 2008), and oropharynx/hypopharynx/larynx (Slater et al., 1992; Cozzi et al., 2001; Johansson et al., 2004; Steneker et al., 2006). Lomax et al. (2003) have also demonstrated the potential for dose escalation during treatment of head and neck cancers with proton therapy based on dosimetric work. "
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    • "3D conformal and intensity-modulated (IMRT) radiotherapy allow more conformal dose distributions and hence improved normal tissue sparing. Various planning studies were already able to demonstrate that especially patients with sinunasal tumours highly profit from modern RT-techniques [8-13]. Chen et al performed a retrospective analysis over five decades in their institution and could impressively show that also in practice introduction of new radiotherapy treatment techniques led to reduction of accompanying side-effects [14,15]. "
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    • "Chera et al.[49] conducted a study comparing the dose-volume data between 3D-CPT and IMRT for a T4N0 maxillary sinus carcinoma. The target volume dose distributions were comparable for 3D-CPT and IMRT. "
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