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J Korean Soc Ther Radiol Oncol > Volume 25(2); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(2): 118-124.
Result of Radiation Therapy of Sino-nasal Cancers Using Partial Attenuation Filter
Jin Hee Kim, Ok Bae Kim, Tae Jin Choi
1Department of Radiation Oncology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea. jhkim@dsmc.or.kr
2Department of Medical Biophysics and Engineering, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea.
This study was to evaluate the survival and pattern of failure after radiation therapy of sino-nasal cancer using partial attenuation filer and wedged beams and to help radiotherapy planning of sino-nasal cancer.
Between February 1992 and March 2003, 17 patients with sino-nasal cancers underwent radiation therapy using partial attenuation filter at Dongsan Medical Center, Keimyung university. There were 9 male and 8 female patients. Patients' age ranged from 40 to 75 years (median 59 years). There were 10 patients of maxillary sinus cancer, 7 patiens of nasal cancer. The histologic type was squamous cell carcinoma in 11, adenoid cystic carcinoma in 4 and olfactory neuroblastoma in 2. The distribution of clinical stage by the AJCC system was 3 for stage II, 7 for III and 6 for IV. The five patients were treated with radiation alone and 12 patients were treated with surgery and postoperative radiation therapy. The range of total radiation dose delivered to the primary tumor was from 44 to 76 Gy (median 60 Gy). The follow- up period ranged from 3 to 173 months with median of 78 months.
The overall 2 year survival rate and disease free survival rate was 76.4%. The 5 year and 10 year survival rate were 76.4% and 45.6% and the 5 year and 10 year disease free survival rate was 70.6%. The 5 year disease free survival rate by treatment modality was 91.6% for postoperative radiation group and 20% for radiation alone group, statistical significance was found by treatment modality (p=0.006). There were no differences in survival by pathology and stage. There were local failure in 5 patients (29%) but no distant failure and no severe complication required surgical intervention.
Radiation therapy of sino-nasal cancer using partial attenuation filter was safe and effective. Combined modality with conservative surgery and radiation therapy was more advisable to achieve loco-regional control in sino-nasal cancer. Also we considered high precision radiation therapy with dose escalation and development of multi-modality treatment to improve local control and survival rate in advanced sino-nasal cancer
Key Words: Sino-nasal cancer, Partial attenuation filter, Radiation, Survival, Patterns of failure
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