Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation

Persistent Link:
http://hdl.handle.net/10150/610183
Title:
Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation
Author:
Chi, Alexander; Nguyen, Nam; Tse, William; Sobremonte, Gill; Concannon, Patrick; Zhu, Angela
Affiliation:
Department of Radiation Oncology, West Virginia University, 1 Medical Center Dr. Morgantown, Morgantown, WV 26506, USA; Department of Radiation Oncology, University of Arizona, Tucson, AZ, 85724, USA; Department of Hematology Oncology, West Virginia University, Morgantown, WV, 26506, USA; Department of Radiation Oncology, Michael E. Debakey VA Medical Center, Houston, TX, 77030, USA
Issue Date:
2013
Publisher:
BioMed Central
Citation:
Chi et al. Journal of Hematology & Oncology 2013, 6:4 http://www.jhoonline.org/content/6/1/4
Journal:
Journal of Hematology & Oncology
Rights:
© 2013 Chi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
PURPOSE:To assess if intensity-modulated radiotherapy (IMRT) can possibly lead to improved local control and lower incidence of vision impairment/blindness in comparison to non-IMRT techniques when treating sinonasal malignancies; what is the most optimal dose constraints for the optic pathway; and the impact of different IMRT strategies on optic pathway sparing in this setting.METHODS AND MATERIALS:A literature search in the PubMed databases was conducted in July, 2012.RESULTS:Clinical studies on IMRT and 2D/3D (2 dimensional/3 dimensional) RT for sinonasal malignancies suggest improved local control and lower incidence of severe vision impairment with IMRT in comparison to non-IMRT techniques. As observed in the non-IMRT studies, blindness due to disease progression may occur despite a lack of severe toxicity possibly due to the difficulty of controlling locally very advanced disease with a dose less than or equal to] 70Gy. Concurrent chemotherapy's influence on the the risk of severe optic toxicity after radiotherapy is unclear. A maximum dose of less than or equal to] 54Gy with conventional fractionation to the optic pathway may decrease the risk of blindness. Increased magnitude of intensity modulation through increasing the number of segments, beams, and using a combination of coplanar and non-coplanar arrangements may help increase dose conformality and optic pathway sparing when IMRT is used.CONCLUSION:IMRT optimized with appropriate strategies may be the treatment of choice for the most optimal local control and optic pathway sparing when treating sinonasal malignancy.
EISSN:
1756-8722
DOI:
10.1186/1756-8722-6-4
Keywords:
Intensity modulated radiotherapy; Sino-nasal malignancies; Optic toxicity; Blindness
Version:
Final published version
Additional Links:
http://www.jhoonline.org/content/6/1/4

Full metadata record

DC FieldValue Language
dc.contributor.authorChi, Alexanderen
dc.contributor.authorNguyen, Namen
dc.contributor.authorTse, Williamen
dc.contributor.authorSobremonte, Gillen
dc.contributor.authorConcannon, Patricken
dc.contributor.authorZhu, Angelaen
dc.date.accessioned2016-05-20T09:00:31Z-
dc.date.available2016-05-20T09:00:31Z-
dc.date.issued2013en
dc.identifier.citationChi et al. Journal of Hematology & Oncology 2013, 6:4 http://www.jhoonline.org/content/6/1/4en
dc.identifier.doi10.1186/1756-8722-6-4en
dc.identifier.urihttp://hdl.handle.net/10150/610183-
dc.description.abstractPURPOSE:To assess if intensity-modulated radiotherapy (IMRT) can possibly lead to improved local control and lower incidence of vision impairment/blindness in comparison to non-IMRT techniques when treating sinonasal malignanciesen
dc.description.abstractwhat is the most optimal dose constraints for the optic pathwayen
dc.description.abstractand the impact of different IMRT strategies on optic pathway sparing in this setting.METHODS AND MATERIALS:A literature search in the PubMed databases was conducted in July, 2012.RESULTS:Clinical studies on IMRT and 2D/3D (2 dimensional/3 dimensional) RT for sinonasal malignancies suggest improved local control and lower incidence of severe vision impairment with IMRT in comparison to non-IMRT techniques. As observed in the non-IMRT studies, blindness due to disease progression may occur despite a lack of severe toxicity possibly due to the difficulty of controlling locally very advanced disease with a dose less than or equal to] 70Gy. Concurrent chemotherapy's influence on the the risk of severe optic toxicity after radiotherapy is unclear. A maximum dose of less than or equal to] 54Gy with conventional fractionation to the optic pathway may decrease the risk of blindness. Increased magnitude of intensity modulation through increasing the number of segments, beams, and using a combination of coplanar and non-coplanar arrangements may help increase dose conformality and optic pathway sparing when IMRT is used.CONCLUSION:IMRT optimized with appropriate strategies may be the treatment of choice for the most optimal local control and optic pathway sparing when treating sinonasal malignancy.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.jhoonline.org/content/6/1/4en
dc.rights© 2013 Chi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectIntensity modulated radiotherapyen
dc.subjectSino-nasal malignanciesen
dc.subjectOptic toxicityen
dc.subjectBlindnessen
dc.titleIntensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservationen
dc.typeArticleen
dc.identifier.eissn1756-8722en
dc.contributor.departmentDepartment of Radiation Oncology, West Virginia University, 1 Medical Center Dr. Morgantown, Morgantown, WV 26506, USAen
dc.contributor.departmentDepartment of Radiation Oncology, University of Arizona, Tucson, AZ, 85724, USAen
dc.contributor.departmentDepartment of Hematology Oncology, West Virginia University, Morgantown, WV, 26506, USAen
dc.contributor.departmentDepartment of Radiation Oncology, Michael E. Debakey VA Medical Center, Houston, TX, 77030, USAen
dc.identifier.journalJournal of Hematology & Oncologyen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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