Small cell undifferentiated carcinoma of the maxillary sinus: technical considerations for radiation therapy

Treatment principles for extrapulmonary small cell undifferentiated carcinoma follow those established for primary lung presentations including systemic chemotherapy and prophylactic cranial irradiation. Radiation of carcinoma involving the maxillary sinus includes lateral and anterior portals which exit through the brain. Presented is a treatment strategy used for postoperative radiation of small cell undifferentiated carcinoma of the maxillary sinus in conjunction with prophylactic cranial irradiation. Specifics of dosimetry include achievement of 55 to 60 Gy within the tumor volume of the maxillary sinus, while achieving homogeneity of dose (30 Gy) within the cranial contents. Application of the described technique to analogous clinical presentations is also discussed.