Multidisciplinary
Head and Neck Cancer Symposium
Proton beam radiation therapy demonstrated encouraging outcomes in
patients with locally advanced sinonasal malignancies, according to findings
presented by Annie Chan, MD, at the Multidisciplinary Head and Neck
Cancer Symposium in Chandler, Ariz.
“When compared to other studies, our results are very
encouraging,” said Chan, assistant professor of radiation oncology and a
radiation oncologist at Massachusetts General Hospital at Harvard Medical
School, during a news briefing.
Typically, conventional radiation therapy results in poor local control
rate and is associated with treatment-related toxicity due to the anatomical
location of sinonasal malignancies. Researchers conducted this study to
determine the long-term treatment outcome and prognostic factors in these
patients when treated with proton beam therapy.
Ninety-nine patients with newly diagnosed sinonasal cancers were
assigned to proton beam therapy between 1991 and 2003. Sixty-seven percent of
patients had surgery prior to radiation; the median total dose to the primary
tumor was 70 Gy. Median follow-up was 8.5 years.
The five-year local control rate was 87% and the eight-year local
control rate was 83%. No statistically significant difference was observed in
local control per histological subtype, T stage and surgery vs. biopsy. The
distant metastasis–free survival rate was 69% at five and eight years.
Results of a multivariate analysis indicated that only T4b disease was
associated with a decreased distant metastases-free survival (P=.024).
OS was 57% at five years and 46% at eight years. T4b disease
(P=.001), squamous cell carcinoma (P=.002), and Karnofsky
performance status <80 (P=.005) were all associated with decreased
OS, according to the results of a multivariate analysis.
At five years, freedom from grade-3 or higher late toxicity was 78%. For
five-year grade-3 or higher late toxicity, the rate was 29% for patients with
surgery before radiation and 7% for patients without surgery before radiation
(P=.07). Soft tissue toxicity was the most common grade-3 or higher
adverse event. – by Christen Haigh
For more information:
- Cianchetti M. #3. Presented at: Multidisciplinary Head and Neck
Cancer Symposium; Feb. 25-27, 2010; Chandler, Ariz.
More Meeting
Highlights>>
Follow HemOncToday.com
on Twitter.