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Radiation therapy for sinonasal inverted papilloma
Michael Rutenberg1, Jessica Kirwan1, Christopher G Morris1
1Department of Radiation Oncology, University of Florida, Gainesville, Florida.
Practical Radiation Oncology
|March 29, 2014
Summary
Radiation therapy for inverted papilloma (IP) shows moderate long-term survival, but local control remains challenging, especially when IP is associated with squamous cell carcinoma (IP-SCC). Careful consideration is advised for specific patient groups.
Area of Science:
- Otolaryngology
- Radiation Oncology
- Head and Neck Surgery
Background:
- Inverted papilloma (IP) is a rare benign tumor of the sinonasal tract.
- Surgery is the primary treatment for IP, but recurrence and malignant transformation can occur.
Purpose of the Study:
- To evaluate the long-term outcomes of patients with inverted papilloma (IP) treated with radiation therapy.
- To assess the efficacy and toxicity of radiation therapy in managing advanced, recurrent, or malignant IP.
Main Methods:
- Retrospective review of 13 patients with IP treated with radiation therapy between 1969 and 2008.
- Analysis of treatment modalities including surgery, radiation dose, and fractionation schedules.
- Evaluation of survival rates, local-regional control, and treatment-related toxicities.
Main Results:
- Median follow-up was 16.2 years; 15-year overall and cause-specific survival rates were 62% and 82%.
- Fifteen-year local-regional control rates were 45% overall, but significantly lower (16%) for IP associated with squamous cell carcinoma (IP-SCC) compared to IP alone (80%).
- Common toxicities included mucositis and pain; severe complications like CNS radionecrosis were rare.
Conclusions:
- Radiation therapy can be considered for IP, particularly in cases of IP-SCC, multiply recurrent IP, or incompletely resectable IP.
- While associated with a low risk of severe complications, local failure remains a significant challenge.
- Further research into optimizing radiation strategies for IP is warranted.
