The use of intensity modulated radiotherapy for the treatment of extensive and recurrent juvenile angiofibroma

These case series are presented to describe the application and advantages of intensity modulated radiotherapy (IMRT) for the treatment of extensive and/or recurrent juvenile angiofibroma. Two patients were diagnosed with recurrence at 11 and 13 months postoperatively, and one was surgically unresec...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2000-05, Vol.52 (3), p.261-268
Main Authors: Kuppersmith, Ronald B, Teh, Bin S, Donovan, Donald T, Mai, Wei-Yuan, Chiu, J.Kam, Woo, Shiao Y, Butler, E.Brian
Format: Article
Language:English
Subjects:
Adult
Angiofibroma - pathology
Angiofibroma - radiotherapy
Child
Computer-assisted treatment planning
Head and Neck Neoplasms - radiotherapy
Humans
Intensity modulation
Juvenile angiofibroma
Male
Nasopharyngeal Neoplasms - radiotherapy
Neoplasm Invasiveness
Neoplasm Recurrence, Local - radiotherapy
Nose Neoplasms - radiotherapy
Radiotherapy
Radiotherapy Dosage
Radiotherapy, Conformal
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Summary:These case series are presented to describe the application and advantages of intensity modulated radiotherapy (IMRT) for the treatment of extensive and/or recurrent juvenile angiofibroma. Two patients were diagnosed with recurrence at 11 and 13 months postoperatively, and one was surgically unresectable. The affected areas included the base of skull, cavernous sinus, pterygopalatine fossa, infratemporal fossa, posterior orbit and nasopharynx. Highly conformal IMRT was delivered with limited radiation doses to the optic nerves, optic chiasm, brainstem, brain, spinal cord, lens, retina, mandible, and parotid. The total dose delivered to the tumor varied from 3400 to 4500 cGy. The tumor shrunk radiographically in all three cases and there was no endoscopic evidence of disease in two cases at 15 months and 40 months. There was no acute toxicity. Late toxicity was limited to one episode of epistaxis and persistent rhinitis in one patient. In conclusion, IMRT provides several advantages over conventional radiotherapy in the treatment of recurrent juvenile angiofibroma.
ISSN:0165-5876
1872-8464
DOI:10.1016/S0165-5876(00)00297-4