Author(s) :
Konstantin Gordon1,2, Igor Gulidov1, Danil Gogolin1, Olga Lepilina2, Olga Golovanova3, Alexey Semenov1, Sergey Dujenko4, Kira Medvedeva1,
Sergey Koryakin4, Sergey Ivanov5, Andrey Kaprin6
1 Department of Proton Therapy, A. Tsyb Medical Radiological Research Center, Obninsk, Russia
2 Department of Histology, Cytology, and Embryology, Medical Institution, People’s Friendship University of Russia, Moscow, Russia
3 Department of Dosimetry, A. Tsyb Medical Radiological Research Center, Obninsk, Russia
4 Department of Radiophysics, A. Tsyb Medical Radiological Research Center, Obninsk, Russia
5 A. Tsyb Medical Radiological Research Center, Obninsk, Russia
6 National Medical Research Radiological Center, Moscow, Russia
Corresponding author: Konstantin Gordon, Email: dr_gordon@yahoo.com
Published: Journal of Medical and Radiation Oncology 1 (2021) 75-81, , , - DOI: 10.53011/JMRO.2021.01.08
Abstract
Head and neck (H&N) cancers are in the 7-8th place among all types of cancer. Despite novel approaches in cancer treatment, most of the patients have a high risk of loco-regional recurrence.
Esthesioneuroblastoma (ENB) is a very rare H&N neoplasm, accounting for only 3-6% of all intranasal tumors. These tumors usually are presented with locally advanced stages and required radiotherapy as a part of the comprehensive treatment. Loco-regional failures represent a challenge, and re-irradiation can be effective for some groups of patients. We present a case of re-irradiation with protons of sinonasal tumor in a 49-years old patient with recurrent ENB, involving visual structures. We achieved a 5-year positive local control after the proton therapy (PT), without significant toxicity. The case shows an example of re-irradiation as an essential area for PT application, given the need to maximize the treatment’s efficacy and minimize the risk of severe toxicity.
Table 1. Approximate cumulative BED to the OARs (a/b = 3)
Optic nerve R (Dmax) | Optic nerve L (Dmax) | Chiasma
(Dmax) |
Temporal lobe R
(Dmean) |
Temporal lobe L
(Dmean) |
Whole-brain
(Dmean) |
Brain stem (Dmax) | Cochlea R (Dmean) | Cochlea L (Dmean) |
|
2001 (60Co,60Gy) |
120 | 120 | 120 | 68 | 26 | 20 | 120 | 56 | 56 |
2016 (PT,50GyRBE) |
78.6 | 85.5 | 72 | 6 | 2.6 | 3 | 92.6 | 32.6 | 23.6 |
Total BED | 198.6 | 205.5 | 192 | 72 | 28.6 | 23 | 212.6 | 88.6 | 79.6 |