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Feasibility of reirradiation of recurrent sinonasal carcinoma in the periorbital region using hypofractionated image‐guided intensity‐modulated radiation therapy
Author(s) -
Thiagarajan Anuradha,
Mechalakos James,
Lee Nancy
Publication year - 2011
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21385
Subject(s) - medicine , radiation therapy , radiology , orbit (dynamics) , image guided radiation therapy , carcinoma , lesion , nuclear medicine , surgery , engineering , aerospace engineering
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