[Radiation treatment in the carcinoma of paranasal sinuses and nasal cavity].

The authors evaluate 32 patients affected by paranasal sinuses and nasal cavity carcinoma observed at Orl-Rt Department of Oncologic Center at Umberto l(zero) Hospital in Mestre (VE), Italy from 1985 to 1994. Among these: 16 maxillary sinus, 10 ethmoid and 6 nasal cavity carcinomas. Histologic diagnosis showed squamous cell carcinoma in 15 cases, adenocarcinoma in 8 cases, lymphoma in 2 cases, transitional cell carcinoma in 2 cases, undifferentiated carcinoma in 2 cases and adenoidocistic carcinoma in 3 cases. The mean age was 64.5 years (range 46-88 years), and mean performance status was 80 (range 60-90). Four patients had lymphonodal involvement. Eleven patients were operated, eight of them radically. All patients were treated with radiation therapy. Treatment planning was performed using Theraplan V05-B program, on extensive number of CT scans. The minimal tumor dose was 50 Gy for patients operated radically and was 60 Gy with maximum of 73-80 Gy for the others. The follow-up is 39.7 months (range 10-108). Three patients treated with radical surgery developed local relapses, two of them died. Fourteen patients treated with non radical or diagnostic surgery and radiotherapy obtained local complete remission, five of them developed local relapses inside treatment volume. Ten patients died (eight for neoplastic disease). The 3 years, 5-years and 7-years overall survival are respectively 72% and 51%. The 5-years and 7-years disease free survival rate are respectively 48% and 19% with median at 3.7 years. Complication have been minimal. Only one patient affected by glaucoma had a severe and permanent reduction of the virus. The authors conclude that 2D and 3D treatment planning can assure a better accuracy for target definition and a better precision of the treatment with a reduction of complications.