Intensity-modulated radiotherapy with carbon ion boost for high-risk sinonasal squamous cell carcinoma: clinical outcomes and the management of the node-negative neck
Background - Local control of high-risk sinonasal squamous cell carcinoma (SCC) remains challenging and often involves significant morbidity. Management of the node-negative neck is still debated. This study evaluated treatment outcomes, neck management strategies, and toxicity rates in patients tre...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 2026
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| In: |
Clinical and translational radiation oncology
Year: 2026, Volume: 56, Pages: 1-8 |
| ISSN: | 2405-6308 |
| DOI: | 10.1016/j.ctro.2025.101064 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ctro.2025.101064 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2405630825001569 
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| Author Notes: | Lukas Bauer, Katharina Weusthof, Sebastian Regnery, Maximilian Deng, Philipp Schröter, Florian Stritzke, Nils Netzer, Henrik Franke, Kristin Uzun-Lang, Julius Moratin, Oliver Ristow, Rubens Thoelken, Semi B. Harrabi, Klaus Herfarth, Sebastian Adeberg, Jürgen Debus, Thomas Held |
| Summary: | Background - Local control of high-risk sinonasal squamous cell carcinoma (SCC) remains challenging and often involves significant morbidity. Management of the node-negative neck is still debated. This study evaluated treatment outcomes, neck management strategies, and toxicity rates in patients treated with intensity-modulated radiotherapy (IMRT) combined with a carbon ion boost. - Methods - We evaluated 43 patients with sinonasal SCC treated with IMRT and carbon ion boost between 2011 and 2019. Follow-up followed head and neck cancer guidelines. Patient and tumor characteristics, treatment outcomes, and toxicity (per CTCAE v5.0) were assessed. Statistical analysis was performed using R version 4.1.0. - Results - Median age was 64 years (range 19-83). Most patients had T3-4 tumors (n = 36; 83.7 %) and were clinically node-negative (n = 40; 93.0 %). The predominant regimen was 24 Gy (RBE) carbon ion boost in 8 fractions, followed by 50 Gy IMRT in 25 fractions. Postoperative RT was delivered to 25 patients (58.1 %), while 18 (41.9 %) received definitive RT. Elective or therapeutic neck dissection was performed in 10 patients (23.3 %), none showing lymph node metastases. In total, 22 distinct cervical lymph node treatment strategies were applied. Median follow-up for overall survival (OS) was 25.1 months. Tumor recurrence occurred in 11 patients (25.6 %), primarily due to local failure (n = 7; 63.6 %). OS and local progression-free survival (L-PFS) at 12/24 months were 93.0 %/89.3 % and 88.4 %/79.0 %, respectively. Grade III acute and late toxicity occurred in 9.3 % and 4.7 % of patients, respectively. No grade IV toxicity was reported. Mean numbers of grade I-II toxicities per patient were 4.8 (acute) and 2.4 (late). - Conclusion - IMRT with carbon ion boost provides promising OS and local control in high-risk sinonasal SCC. The management of the node-negative-neck was highly individualized. Toxicity was acceptable and may be further reduced by tailoring cervical lymph node treatment in selected patients. |
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| Item Description: | Online verfügbar: 27. Oktober 2025, Artikelversion: 05. November 2025 Gesehen am 12.03.2026 |
| Physical Description: | Online Resource |
| ISSN: | 2405-6308 |
| DOI: | 10.1016/j.ctro.2025.101064 |