Doi Hiroshi, Kitajima Kazuhiro, Tanooka Masao, Terada Tomonori, Noguchi Kazuma, Takada Yasuhiro, Fujiwara Masayuki, Ishikura Reiichi, Kamikonya Norihiko, Hirota Shozo
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Division of Nuclear Medicine and PET center, Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4485-4492. doi: 10.1007/s00405-016-4151-x. Epub 2016 Jun 17.
The purpose of our study was to assess the feasibility of radiotherapy (RT) for locally advanced paranasal sinus carcinomas in late elderly patients (aged ≥75 years) from a single institution in Japan. From 2000 to 2015, we retrospectively analyzed 14 patients (11 maxillary and 3 ethmoid sinus carcinoma patients) who underwent RT for pathologically confirmed paranasal sinus carcinomas. RT was performed without unexpected cessations. Two patients, however, developed Grade 3 mucositis. The median follow-up duration was 13 months (range 2-54 months). The 1- and 2-year overall survival (OS) rates were 81.8 and 54.5 %, respectively. The local response rate after the initial treatment was 85.7 %. The 1- and 2-year progression-free survival (PFS) rates were 46.2 and 24.8 %, respectively. Univariate analysis of different clinicopathological parameters was conducted to identify associations with OS and PFS. We demonstrated that intensity modulated radiation therapy (IMRT) of >60 Gy with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy led to improved OS and PFS rates, although no statistical significance was observed. Moreover, none of the squamous cell carcinoma (SCC) patients who received 33 fractions of 66 Gy in IMRT died during the median follow-up period of 13 months (range 12-25 months). In conclusion, RT with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy can be considered an effective, well-tolerated, and feasible treatment option for late elderly patients with paranasal sinus carcinomas. In addition, >60 Gy of RT in IMRT led to improved survival outcomes in elderly paranasal sinus carcinoma patients.
我们研究的目的是评估在日本一家机构中，对高龄晚期（年龄≥75岁）局部晚期鼻窦癌患者进行放射治疗（RT）的可行性。2000年至2015年期间，我们回顾性分析了14例经病理确诊为鼻窦癌并接受RT治疗的患者（11例上颌窦癌和3例筛窦癌患者）。RT治疗过程中没有意外中断。然而，有2例患者发生了3级黏膜炎。中位随访时间为13个月（范围2 - 54个月）。1年和2年总生存率（OS）分别为81.8%和54.5%。初始治疗后的局部缓解率为85.7%。1年和2年无进展生存率（PFS）分别为46.2%和24.8%。对不同临床病理参数进行单因素分析以确定与OS和PFS的相关性。我们发现，强度调制放射治疗（IMRT）剂量>60 Gy并联合动脉内（基于顺铂）灌注化疗放疗可提高OS和PFS率，尽管未观察到统计学意义。此外，在13个月（范围12 - 25个月）的中位随访期内，接受IMRT 66 Gy共33次分割治疗的鳞状细胞癌（SCC）患者均未死亡。总之，RT联合动脉内（基于顺铂）灌注化疗放疗可被认为是高龄晚期鼻窦癌患者一种有效、耐受性良好且可行的治疗选择。此外，IMRT中>60 Gy的RT可改善老年鼻窦癌患者的生存结局。
