Abstract 23P
Background
Nasal cavity and paranasal sinus tumors are relatively rare head and neck malignancies. Surgery followed by post operative radiotherapy is a commonly used treatment approach for these tumors. The aim of this study was to evaluate recurrence patterns and treatment outcomes in patients undergoing post operative radiotherapy using volumetric modulated arc therapy (VMAT).
Methods
Patients with nasal cavity and paranasal sinus cancers were included in this retrospective analysis. All patients were planned for post operative VMAT using 6MV photons. Statistical analysis was done using SPSSv.20. Univariable cox regression analysis was done to evaluate relationship between recurrence patterns and patient, tumor and treatment variables. Kaplan-Meir analysis was used for survival analysis. A p value of <0.05 was considered significant.
Results
Fifty patients were evaluated and included malignancies of the nasal cavity (68%), maxillary sinus (26%), ethmoid (2%) & sphenoid sinus (1%). Squamous cell carcinoma was the most common histology (42%). Other variants included adenoid cystic carcinomas (22%), esthesioneuroblastoma (18%), adenocarcinoma (4%) & small cell carcinoma (2%). Stage IV, III & II disease was seen in 44%, 30% & 8 % patients. Nine patients had Kadish C esthesioneuroblastomas. Functional endoscopic sinus surgery was done in 42% patients. Other surgical procedures included maxillectomy in 28%, wide local excision in 28% & orbital exenteration in 2%. Post operative radiotherapy dose ranged from 50-60 Gy. Neoadjuvant & adjuvant chemotherapy was given in 12% & 16% patients only. At 3 year follow up recurrences were seen in 34% patients. Local, local & nodal & nodal recurrence were seen in 20%, 4% & 4%. Distant metastasis were seen in 6% cases. On univariate analysis patient with age less than 40 years had more recurrences (53.3% versus 25.7%) than those with age more than 40 years(p=0.05). Intracranial extension was another adverse prognostic factor with recurrence seen in 83.3% versus 27.3% (p=0.007). The median disease-free survival was 24± 2.71 months. The overall survival at 3 years was 72%.
Conclusions
Age less than 40 years and intracranial involvement at presentation emerged as poor prognostic factors for recurrences.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Dr Amit Bahl.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.