Radiation therapy for sinonasal inverted papilloma |
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| Authors: | Michael Rutenberg Jessica Kirwan Christopher G Morris John W Werning William M Mendenhall |
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| Institution: | 1. Department of Radiation Oncology, University of Florida, Gainesville, Florida;2. Department of Otolaryngology, University of Florida, Gainesville, Florida;1. Senior Lecturer, Department of Public Health Dentistry, Narayana Dental College & Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India;2. Professor and Head, Department of Public Health Dentistry, Narayana Dental College & Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India;3. Associate Professor, Department of Endocrine Surgery, Narayana Medical College, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India;4. Professor, Department of Public Health Dentistry, Narayana Dental College & Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India;5. Assistant Professor, Department of Biochemistry, Narayana Medical College, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India;6. Assistant Professor, Department of Endocrinology, Narayana Medical College, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India;1. Department of Oral Medicine, Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran;2. Physiology in Unusual States Research Center, Department of Physiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran;1. Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands;2. Department of Biostatistics, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands;1. Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden;2. Department of Dental Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden;3. Department of Nephrology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden |
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| Abstract: | PurposeWe retrospectively reviewed long-term outcomes of patients with inverted papilloma (IP) treated with radiation therapy at our institution.Methods and MaterialsFrom 1969 to 2008, 13 patients with advanced or recurrent IP (n = 12) or cylindrical papilloma (n = 1) were treated with radiation therapy. The median age at radiation therapy was 53 years old (range, 32-84). Nine patients received postoperative radiation therapy, 3 received definitive radiation therapy, and 1 received preoperative radiation therapy. Of the 10 patients treated with combined-modality treatment, 1 underwent craniofacial resection and 9 underwent open resection. Eight patients, 4 patients, and 1 patient received once-daily fractionation, twice-daily fractionation, and planned split-course radiation therapy, respectively, to a median dose of 65 Gy (range, 45.3-70.4 Gy).ResultsThe median follow-up was 16.2 years. Actuarial 15-year overall and cause-specific survival rates were 62% and 82%. Fifteen-year actuarial local and regional control rates were 45% and 73%. Fifteen-year local-regional control rates for IP alone and IP associated with squamous cell carcinoma (IP-SCC) at the time of treatment were 80% and 16%. Fifteen-year overall survival rates for IP alone and IP-SCC were 40% and 50%. The only severe treatment complication was a grade 3 central nervous system radionecrosis. The most common grade 1-2 toxicities were mucositis (61%), pain (46%), conjunctivitis (31%), xerostomia (31%), epiphora (31%), and anorexia (31%).ConclusionsWhile surgery is the primary treatment for IP, radiation therapy should be considered in patients with SCC, multiply recurrent IPs, and incompletely resectable IP. Radiation therapy is associated with a relatively low risk of severe complications. Despite more aggressive treatment, local failure remains a considerable challenge. |
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