Reassessment of technical and biological factors in paranasal sinus carcinoma

Twenty-seven patients with paranasal sinus carcinoma were analyzed. Local control with radiation alone was poor, with most patients failing centrally within the primary site. With preoperative radiation local control is 60%. Previous reports have emphasized failure at superior sites--particularly the orbit. The pattern of local failure in our series is predominantly various medial sites inclusive of intact or exenterated orbit. The surgically nonremovable medial structures are best encompassed by a three-field radiotherapy technique (weighted anterior and two laterals).