Radiation oncology for the rhinologist.

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2024-02-01 Epub Date: 2023-11-30 DOI:10.1097/MOO.0000000000000942

Helena Levyn, Fan Yang, Nancy Y Lee

{"title":"Radiation oncology for the rhinologist.","authors":"Helena Levyn, Fan Yang, Nancy Y Lee","doi":"10.1097/MOO.0000000000000942","DOIUrl":null,"url":null,"abstract":"Purpose of review: This comprehensive review explores evolving treatment strategies for sinonasal and nasopharyngeal malignancies. It analyzes the role of adjuvant radiotherapy, the potential of intensity-modulated proton therapy (IMPT), and the relevance of de-escalation strategies nasopharyngeal carcinoma (NPC). Additionally, it discusses hyperfractionation in re-irradiation in NPC.Recent findings: Adjuvant radiotherapy remains pivotal for sinonasal tumors, improving locoregional control and survival, notably in squamous cell carcinomas, adenocarcinomas, and adenoid cystic carcinomas. IMPT promises enhanced outcomes by sparing healthy tissues, potentially improving patients' quality of life. For select stage II/T3N0 NPC, radiotherapy alone offers comparable outcomes to concurrent chemoradiotherapy, with fewer adverse events and improved quality of life. Selective neck irradiation in NPC patients with uninvolved necks maintains oncologic outcomes while reducing late toxicity. Hyperfractionation in re-irradiation shows promise in lowering late toxicities and improving overall survival, particularly in undifferentiated sinonasal carcinomas.Summary: This review underscores the significance of adjuvant radiotherapy and the potential of advanced radiation techniques in optimizing sinonasal and nasopharyngeal malignancy outcomes. It emphasizes evolving de-escalation methods and individualized, evidence-based approaches. Future research will further refine strategies for these challenging malignancies.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"5-13"},"PeriodicalIF":1.9000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Otolaryngology & Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MOO.0000000000000942","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: This comprehensive review explores evolving treatment strategies for sinonasal and nasopharyngeal malignancies. It analyzes the role of adjuvant radiotherapy, the potential of intensity-modulated proton therapy (IMPT), and the relevance of de-escalation strategies nasopharyngeal carcinoma (NPC). Additionally, it discusses hyperfractionation in re-irradiation in NPC.

Recent findings: Adjuvant radiotherapy remains pivotal for sinonasal tumors, improving locoregional control and survival, notably in squamous cell carcinomas, adenocarcinomas, and adenoid cystic carcinomas. IMPT promises enhanced outcomes by sparing healthy tissues, potentially improving patients' quality of life. For select stage II/T3N0 NPC, radiotherapy alone offers comparable outcomes to concurrent chemoradiotherapy, with fewer adverse events and improved quality of life. Selective neck irradiation in NPC patients with uninvolved necks maintains oncologic outcomes while reducing late toxicity. Hyperfractionation in re-irradiation shows promise in lowering late toxicities and improving overall survival, particularly in undifferentiated sinonasal carcinomas.

Summary: This review underscores the significance of adjuvant radiotherapy and the potential of advanced radiation techniques in optimizing sinonasal and nasopharyngeal malignancy outcomes. It emphasizes evolving de-escalation methods and individualized, evidence-based approaches. Future research will further refine strategies for these challenging malignancies.

查看原文本刊更多论文

鼻科医生的放射肿瘤学。

综述的目的：这篇综合综述探讨了鼻窦和鼻咽恶性肿瘤不断发展的治疗策略。它分析了辅助放疗的作用、调强质子治疗（IMPT）的潜力以及去升级策略鼻咽癌（NPC）的相关性。此外，报告还讨论了鼻咽癌再照射中的超分割治疗：最近的研究结果：辅助放疗对鼻窦肿瘤仍然至关重要，可改善局部控制和生存率，尤其是对鳞状细胞癌、腺癌和腺样囊性癌。IMPT 通过保留健康组织，有望提高疗效，从而改善患者的生活质量。对于选择性 II/T3N0 期鼻咽癌，单纯放疗的疗效与同期化放疗相当，不良反应更少，生活质量更高。对颈部未受累的鼻咽癌患者进行选择性颈部照射，既能保持肿瘤治疗效果，又能减少后期毒性。再照射中的超分割治疗有望降低晚期毒性并提高总生存率，尤其是在未分化鼻窦癌中。摘要：这篇综述强调了辅助放疗的重要性以及先进放射技术在优化鼻窦和鼻咽恶性肿瘤疗效方面的潜力。它强调了不断发展的降级方法和个体化的循证方法。未来的研究将进一步完善这些具有挑战性的恶性肿瘤的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Opinion in Otolaryngology & Head and Neck Surgery OTORHINOLARYNGOLOGY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.