Back to Search
Start Over
Radiotherapy as nose preservation treatment strategy for cancer of the nasal vestibule: The Dutch experience
- Source :
- Radiotherapy and Oncology, 164, 20-26. Elsevier Ireland Ltd, Radiotherapy and Oncology, 164, 20-26, Radiotherapy and Oncology, 164, pp. 20-26, Radiotherapy and Oncology, 164, 20-26. ELSEVIER IRELAND LTD
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background and purpose: Primary radiotherapy is often preferred for early-stage cancer of the nasal vestibule (CNV), combining high disease control with preservation of nasal anatomy. However, due to practice variation and an absence of comparative trials, no consensus exists on preference for brachytherapy (BT) or external beam radiotherapy (EBRT). We compared these modalities in terms of disease control, nose preservation rates and toxicity. Materials and methods: Medical records of 225 patients with T1-T2 squamous cell carcinoma of the nasal vestibule treated with 3D image-guided primary radiotherapy between Jan 2010 and Dec 2016 in 6 Dutch institutions were reviewed retrospectively. Results: 153 of 225 patients were treated with BT, 65 with EBRT and 7 with other modalities. Median follow-up was 46 months. Overall 3-year local control (LC) and regional control (RC) were 87% and 89%. Five-year disease-specific survival (DSS) and overall survival (OS) were 94% and 82%. Three-year survival with preserved nose (SPN) was 76%. BT provided higher 3-year LC (95% vs 71%, p < 0.01) and SPN compared with EBRT (82% vs 61%, p < 0.01). Multivariable and propensity-score-matched cohort analyses confirmed better outcomes after BT. No difference was seen in DSS or OS. Five-year incidence of CTCAE 5.0 grade >2 toxicity was higher after BT (20% vs 3%, p = 0.03) and consisted mostly of radiation ulcers. 50% of all late toxicity recovered. Conclusion: In this largest-to-date multicenter analysis of T1-T2 CNV, BT achieved superior LC and SPN compared with EBRT. Grade 1-2 radiation ulcers occurred more frequently after brachytherapy, but were transient in half the cases. Considering these results, BT can be recommended as first-line treatment for T1-T2 CNV. (c) 2021 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 164 (2021) 20-26 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Brachytherapy
All institutes and research themes of the Radboud University Medical Center
STAGE
SDG 3 - Good Health and Well-being
RADIATION-THERAPY
medicine
Humans
RECONSTRUCTION
Radiology, Nuclear Medicine and imaging
HEAD
External beam radiotherapy
Propensity Score
Head and neck cancer
Nose
Retrospective Studies
Radiotherapy
business.industry
Incidence (epidemiology)
Prostatic Neoplasms
Cancer
Hematology
medicine.disease
Radiation therapy
medicine.anatomical_structure
Oncology
INTERVENTIONAL RADIOTHERAPY
CAVITY
INTERSTITIAL BRACHYTHERAPY
SQUAMOUS-CELL CARCINOMA
Radiology
Nasal vestibule
business
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Radiotherapy, Image-Guided
Subjects
Details
- ISSN :
- 01678140
- Volume :
- 164
- Database :
- OpenAIRE
- Journal :
- Radiotherapy and Oncology
- Accession number :
- edsair.doi.dedup.....3a0dae631e8e26b4198af772bc6c325f
- Full Text :
- https://doi.org/10.1016/j.radonc.2021.08.018