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Updated: Apr 25, 2026

Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
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Predominance of In-Field Recurrence After Radiotherapy for Sinonasal Cancer: A Single-Center Retrospective Study.

M de Ridder1, L J van de Velde2, T de Bie2

  • 1Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.

Head & Neck
|April 23, 2026
PubMed
Summary
This summary is machine-generated.

Most local recurrences after radiotherapy for sinonasal malignancies occur within the high-dose area, suggesting radioresistance. This highlights the need for tailored treatment strategies based on tumor histology to improve outcomes for these rare cancers.

Keywords:
malignancyradiotherapyrecurrencesinonasal cancer

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Area of Science:

  • Radiation Oncology
  • Head and Neck Oncology
  • Medical Physics

Background:

  • Sinonasal malignancies (SNM) are rare and aggressive tumors with poor prognoses.
  • Current radiotherapy (RT) strategies for SNM lack optimization, necessitating improved treatment approaches.
  • Advances in imaging and molecular classification have not yet translated into definitive RT guidelines.

Purpose of the Study:

  • To analyze patterns of local recurrence after curative-intent radiotherapy for sinonasal malignancies.
  • To investigate the location of local recurrences relative to the high-dose radiation volume.
  • To identify factors influencing treatment failure and survival in SNM patients receiving RT.

Main Methods:

  • Retrospective cohort study of 104 SNM patients treated with curative RT (2010-2022).
  • Local recurrences were identified on follow-up imaging and mapped to pretreatment RT plans.
  • Recurrence location (in-field, marginal, out-of-field) was determined based on radiation dose distribution.

Main Results:

  • A local recurrence rate of 25% was observed in the study cohort.
  • The majority of local recurrences (81%) occurred in-field, within the prescribed high-dose region (median 65 Gy).
  • Perineural spread was a significant factor in out-of-field failures, and local recurrence negatively impacted disease-specific survival.

Conclusions:

  • Local failures in sinonasal malignancies after RT predominantly occur within adequately irradiated volumes, suggesting intrinsic radioresistance.
  • These findings underscore the critical need for developing histology-driven, biologically tailored radiotherapy strategies for SNM.
  • Optimizing RT requires a deeper understanding of tumor biology and dose-response relationships to overcome treatment resistance.