Fistula formation after postoperative radiation treatment for paranasal sinus cancer

Stephanie A. Terezakis, George C. Bohle, Nancy Y. Lee

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Postoperative radiation is frequently used in the treatment paradigm for paranasal sinus tumors. The development of 3-dimensional conformal radiation treatment and intensity modulated radiotherapy (IMRT) has facilitated the delivery of high doses required for local control of these lesions while simultaneously decreasing toxicity. At Memorial Sloan-Kettering Cancer Center, a radiation dose of 70 Gy is routinely prescribed to gross tumor, and 59.4 Gy is prescribed to a clinical target volume at high risk for subclinical disease and 54 Gy is delivered to a clinical target volume at low risk for subclinical disease. Fistula formation can occur with the delivery of postoperative radiation treatment despite the use of IMRT. Prosthesis fabrication can be used in the short-term management of this unfortunate complication with an acceptable cosmetic result. Patients should be aware of this potential toxicity, which can develop in spite of appropriate management and acceptable dosimetry. Nonetheless, combined modality therapy is recommended for aggressive treatment of paranasal sinus tumors to inhibit local progression. This report describes the clinical scenario and management of the rare incidence of fistula formation after radiation for paranasal sinus malignancy.

Original languageEnglish (US)
Pages (from-to)199-204
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume31
Issue number2
DOIs
StatePublished - Apr 1 2008
Externally publishedYes

Keywords

  • Fistula
  • Paranasal sinus cancer
  • Radiation toxicity in head and neck cancer
  • Side effects of sinus cancer treatment

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