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Feasibility of reirradiation of recurrent sinonasal carcinoma in the periorbital region using hypofractionated image-guided intensity-modulated radiation therapy

✍ Scribed by Anuradha Thiagarajan; James Mechalakos; Nancy Lee


Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
552 KB
Volume
33
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background

Recurrent periorbital tumors pose management challenges because they are often unresectable and chemorefractory. Proximity to critical structures renders reirradiation difficult. With image‐guided intensity‐modulated radiation therapy (IG‐IMRT), real‐time corrections to patient setup are possible, enabling significant shrinkage of planning target volume margins and safe dose escalation with hypofractionation. Here, we present our experience with hypofractionated IG‐IMRT in a patient with multiply recurrent sinonasal carcinomas in the periorbital region.

Methods

The patient is a 67‐year‐old woman with sinonasal carcinoma, treated with surgery and 2 prior courses of high‐dose radiotherapy. She developed a second tumor recurrence in the right lateral orbit, which was reirradiated using hypofractionated IG‐IMRT (24 Gy in 3 fractions).

Results

Near‐complete resolution of her ocular symptoms was observed at 4 months. Progress scans demonstrated a decrease in size of the orbital lesion.

Conclusion

Preliminary results of reirradiation using hypofractionated IG‐IMRT suggest that it is safe and effective. © 2010 Wiley Periodicals, Inc. Head Neck, 2010