Combined photon and carbon ion radiation therapy for sinonasal malignancies: results of the HIT-SNT prospective phase 2 trial
PURPOSE: Radiation treatment of sinonasal malignancies is a challenging task due to proximity to critical structures of the head and neck and skull base. Local tumor control is highly dose-dependent, but dose application is limited due to accompanying toxicity and dose constraints. To evaluate the t...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
1 April 2024
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| In: |
International journal of radiation oncology, biology, physics
Year: 2024, Volume: 118, Issue: 5, Pages: 1563-1574 |
| ISSN: | 1879-355X |
| DOI: | 10.1016/j.ijrobp.2023.09.037 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ijrobp.2023.09.037
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| Author Notes: | Katharina Weusthof, MD, Thomas Held, MD, Kristin Lang, MD, Zoe E. Rachel, Semi B. Harrabi, MD, Karim Plath, MD, Christian Freudlsperger, MD, Klaus Herfarth, MD, Jürgen Debus, MD, PhD, Thomas Haberer, PhD, Marc Münter, MD, Alexandra D. Jensen, MD, and Sebastian Adeberg, MD |
| Summary: | PURPOSE: Radiation treatment of sinonasal malignancies is a challenging task due to proximity to critical structures of the head and neck and skull base. Local tumor control is highly dose-dependent, but dose application is limited due to accompanying toxicity and dose constraints. To evaluate the toxicity and efficacy of combined radiation treatment with intensity-modulated radiation therapy (IMRT) and carbon ion boost, we conducted a prospective phase 2 IMRT-Heidelberg Ion-Beam Therapy Sinonasal Tumors (HIT-SNT) trial. - METHODS AND MATERIALS: Between 2011 and 2019, we treated 35 patients with histologically proven, incompletely resected or inoperable adeno- (51%) or squamous cell carcinoma (49%) of the paranasal sinuses with combined IMRT (50 Gy) and carbon ion boost (24 Gy relative biologic effectiveness) to a total dose of 74 Gy. - RESULTS: Acute mucositis Common Terminology Criteria for Adverse Events (CTCAE) grade 3 occurred in 12% of patients (n = 4) and was accompanied by odynophagia CTCAE grade 3. Except for 1 case of grade 3 weight loss, no other acute high-grade toxicity (grade 3-4) was observed. In a small patient cohort of 15 patients eligible for long-term follow-up we have seen no high-grade (grade ≥3) long-term side effects 2 years after radiation therapy. None of these patients suffered from therapy-associated vision or hearing loss. Secondary endpoints were 2-year overall survival, 2-year local progression-free survival, 2-year progression-free survival, and 2-year metastases-free survival with 79.4%, 61.8%, 61.8%, and 64.8%, respectively. - CONCLUSIONS: To our knowledge, this is the first prospective data on toxicity and outcome of bimodal radiation therapy for the rare entity of sinonasal malignancies. Our study shows a low rate of CTCAE-reported acute toxicity with reasonable tumor control and survival rates after bimodal radiation therapy, which therefore remains a therapy approach to be further evaluated. |
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| Item Description: | Gesehen am 21.03.2025 Online verfügbar: 20 October 2023, Version of Record: 14 March 2024 |
| Physical Description: | Online Resource |
| ISSN: | 1879-355X |
| DOI: | 10.1016/j.ijrobp.2023.09.037 |