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Daniel J Haraf - One of the best experts on this subject based on the ideXlab platform.

  • Multimodality therapy in advanced Paranasal Sinus Carcinoma: superior long-term results.
    The cancer journal from Scientific American, 1999
    Co-Authors: Everett E. Vokes, Arie Rosen, M E Witt, Ralph R. Weichselbaum, Daniel J Haraf
    Abstract:

    This study was conducted to determine the efficacy of multimodality treatment for stage III and IV, locoregionally advanced Paranasal Sinus Carcinoma. A subgroup analysis of 19 consecutive patients with stage III or IV Paranasal Sinus Carcinoma treated with multimodality therapy from head and neck cancer protocols between 1984 and 1996 were analyzed for outcome. Sixteen patients received induction chemotherapy consisting of three cycles of cisplatin and 5-fluorouracil, followed by traditional resection (14 patients) or surgical debulking (two patients). Surgery was followed by concomitant chemoradiotherapy with hydroxyurea and 5-fluorouracil in a week-on, week-off sequence in 15 patients. One patient received standard radiation therapy. An additional three patients were treated with a sequence of surgical resection followed by concomitant chemoradiotherapy. The median total dose to the primary tumor was 60 Gy (range, 45-74 Gy). The overall survival at 5 and 10 years by lifetable analysis was 72.7% and 53.9%, respectively, and the disease-free survival at both 5 and 10 years was 66.6%. Local control was 76.1% at both 5 and 10 years. In the subgroup of patients treated with induction chemotherapy, 87% (14/16) achieved a clinical response. A complete response was confirmed at the time of surgery in five patients, whereas 11 patients had residual disease in the surgical specimen. Regional and distant failures were unusual (one patient each), with a 10-year regional control rate of 93% and a distant control rate of 95.5%. Serious, nonreversible long-term complications included two cases of unilateral blindness, one cataract, and one case of ototoxicity. An excellent long-term outcome with respect to local control, overall survival, and disease-free survival is achieved in locoregionally advanced Paranasal Sinus cancer treated with induction chemotherapy, surgery, and concomitant chemoradiotherapy. The 15 patients treated with this regimen had 10-year overall survival, disease-free survival, and local control rates of 56%, 73%, and 79%, respectively. These results are encouraging and are superior to the 40% survival achieved with surgery and radiation therapy. Further investigation of this regimen is warranted.

  • Multimodality therapy in advanced Paranasal Sinus Carcinoma: superior long-term results.
    The cancer journal from Scientific American, 1999
    Co-Authors: M.m. Lee, M E Witt, Arie Rosen, Everett E. Vokes, Ralph R. Weichselbaum, Daniel J Haraf
    Abstract:

    Purpose This study was conducted to determine the efficacy of multimodality treatment for stage III and IV, locoregionally advanced Paranasal Sinus Carcinoma. Patients and methods A subgroup analysis of 19 consecutive patients with stage III or IV Paranasal Sinus Carcinoma treated with multimodality therapy from head and neck cancer protocols between 1984 and 1996 were analyzed for outcome. Sixteen patients received induction chemotherapy consisting of three cycles of cisplatin and 5-fluorouracil, followed by traditional resection (14 patients) or surgical debulking (two patients). Surgery was followed by concomitant chemoradiotherapy with hydroxyurea and 5-fluorouracil in a week-on, week-off sequence in 15 patients. One patient received standard radiation therapy. An additional three patients were treated with a sequence of surgical resection followed by concomitant chemoradiotherapy. The median total dose to the primary tumor was 60 Gy (range, 45-74 Gy). Results The overall survival at 5 and 10 years by lifetable analysis was 72.7% and 53.9%, respectively, and the disease-free survival at both 5 and 10 years was 66.6%. Local control was 76.1% at both 5 and 10 years. In the subgroup of patients treated with induction chemotherapy, 87% (14/16) achieved a clinical response. A complete response was confirmed at the time of surgery in five patients, whereas 11 patients had residual disease in the surgical specimen. Regional and distant failures were unusual (one patient each), with a 10-year regional control rate of 93% and a distant control rate of 95.5%. Serious, nonreversible long-term complications included two cases of unilateral blindness, one cataract, and one case of ototoxicity. Discussion An excellent long-term outcome with respect to local control, overall survival, and disease-free survival is achieved in locoregionally advanced Paranasal Sinus cancer treated with induction chemotherapy, surgery, and concomitant chemoradiotherapy. The 15 patients treated with this regimen had 10-year overall survival, disease-free survival, and local control rates of 56%, 73%, and 79%, respectively. These results are encouraging and are superior to the 40% survival achieved with surgery and radiation therapy. Further investigation of this regimen is warranted.

  • Locoregionally advanced Paranasal Sinus Carcinoma. Favorable survival with multimodality therapy.
    Archives of otolaryngology--head & neck surgery, 1993
    Co-Authors: Arie Rosen, Daniel J Haraf, Everett E. Vokes, Ralph R. Weichselbaum, Natan Scher, William R. Panje
    Abstract:

    • To determine the efficacy of multimodality treatment for stage III and IV, advanced Paranasal Carcinoma, we have retrospectively reviewed local control rate and disease-free survival in patients treated at the University of Chicago (III). Twelve consecutive patients with stage III or IV, newly diagnosed Paranasal Sinus Carcinoma treated between 1984 and 1991 were included in this study. Multimodality therapy was composed of a sequence of fluorouracil-cisplatin—based neoadjuvant chemotherapy (in 12 of 12 patients) followed by standard surgical resection (11 of 12 patients) and radiotherapy (12 of 12 patients, 45 to 73 Gy) with or without concomitant chemotherapy. Eleven patients (92%) are currently alive and free of disease, with a median follow-up of 55 months (range, 13 to 105 months). One patient died of persistent disease. Failure was attributed to incomplete surgical resection. There was only one major irreversible treatment complication (cisplatin ototoxic reaction). Our preliminary data suggest improved local control and survival with multimodality therapy that includes systemic neoadjuvant chemotherapy and standard tumor resection in patients with advanced Paranasal Sinus Carcinoma. These results are superior to the reported 40% survival with bimodal therapy and are better than those achieved in our institution for other head and neck primaries with the same treatment regimens. ( Arch Otolaryngol Head Neck Surg. 1993;119:743-746)

Richard Potter - One of the best experts on this subject based on the ideXlab platform.

  • treatment planning comparison of conventional 3d conformal and intensity modulated photon imrt and proton therapy for Paranasal Sinus Carcinoma
    International Journal of Radiation Oncology Biology Physics, 2004
    Co-Authors: Ulrike Mock, Dietmar Georg, Joachim Bogner, Thomas Auberger, Richard Potter
    Abstract:

    Abstract Purpose To determine the potential improvements in patients with Paranasal Sinus Carcinoma by comparing proton and intensity-modulated radiotherapy (IMRT) with conventional and conformal photon treatment planning techniques. Methods and materials In 5 patients, comparative treatment planning was performed by comparing proton plans and related conventional, conformal, and IMRT photon plans. The evaluations analyzed dose–volume histogram findings of the target volumes and organs at risk (OARs, i.e., pituitary gland, optical pathway structures, brain, nontarget tissue). Results The mean and maximal doses, dose inhomogeneities, and conformity indexes for the planning target volumes were comparable for all techniques. Photon plans resulted in greater volumes of irradiated nontarget tissues at the 10–70% dose level compared with the corresponding proton plans. The volumes thereby increased by a factor of 1.3–3.1 for conventional, 1.1–3.8 for conformal, and 1.1–3.7 for IMRT. Compared with conventional techniques, conformal and IMRT photon treatment planning options similarly reduced the mean dose to the OARs. The use of protons further reduced the mean dose to the OARs by up to 65% and 62% compared with the conformal and IMRT technique, respectively. Conclusion Compared with conventional treatment techniques, conformal RT and IMRT similarly enabled dose reductions to the OARs. Additional improvements were obtained using proton-based treatment planning modalities.

Arie Rosen - One of the best experts on this subject based on the ideXlab platform.

  • Multimodality therapy in advanced Paranasal Sinus Carcinoma: superior long-term results.
    The cancer journal from Scientific American, 1999
    Co-Authors: Everett E. Vokes, Arie Rosen, M E Witt, Ralph R. Weichselbaum, Daniel J Haraf
    Abstract:

    This study was conducted to determine the efficacy of multimodality treatment for stage III and IV, locoregionally advanced Paranasal Sinus Carcinoma. A subgroup analysis of 19 consecutive patients with stage III or IV Paranasal Sinus Carcinoma treated with multimodality therapy from head and neck cancer protocols between 1984 and 1996 were analyzed for outcome. Sixteen patients received induction chemotherapy consisting of three cycles of cisplatin and 5-fluorouracil, followed by traditional resection (14 patients) or surgical debulking (two patients). Surgery was followed by concomitant chemoradiotherapy with hydroxyurea and 5-fluorouracil in a week-on, week-off sequence in 15 patients. One patient received standard radiation therapy. An additional three patients were treated with a sequence of surgical resection followed by concomitant chemoradiotherapy. The median total dose to the primary tumor was 60 Gy (range, 45-74 Gy). The overall survival at 5 and 10 years by lifetable analysis was 72.7% and 53.9%, respectively, and the disease-free survival at both 5 and 10 years was 66.6%. Local control was 76.1% at both 5 and 10 years. In the subgroup of patients treated with induction chemotherapy, 87% (14/16) achieved a clinical response. A complete response was confirmed at the time of surgery in five patients, whereas 11 patients had residual disease in the surgical specimen. Regional and distant failures were unusual (one patient each), with a 10-year regional control rate of 93% and a distant control rate of 95.5%. Serious, nonreversible long-term complications included two cases of unilateral blindness, one cataract, and one case of ototoxicity. An excellent long-term outcome with respect to local control, overall survival, and disease-free survival is achieved in locoregionally advanced Paranasal Sinus cancer treated with induction chemotherapy, surgery, and concomitant chemoradiotherapy. The 15 patients treated with this regimen had 10-year overall survival, disease-free survival, and local control rates of 56%, 73%, and 79%, respectively. These results are encouraging and are superior to the 40% survival achieved with surgery and radiation therapy. Further investigation of this regimen is warranted.

  • Multimodality therapy in advanced Paranasal Sinus Carcinoma: superior long-term results.
    The cancer journal from Scientific American, 1999
    Co-Authors: M.m. Lee, M E Witt, Arie Rosen, Everett E. Vokes, Ralph R. Weichselbaum, Daniel J Haraf
    Abstract:

    Purpose This study was conducted to determine the efficacy of multimodality treatment for stage III and IV, locoregionally advanced Paranasal Sinus Carcinoma. Patients and methods A subgroup analysis of 19 consecutive patients with stage III or IV Paranasal Sinus Carcinoma treated with multimodality therapy from head and neck cancer protocols between 1984 and 1996 were analyzed for outcome. Sixteen patients received induction chemotherapy consisting of three cycles of cisplatin and 5-fluorouracil, followed by traditional resection (14 patients) or surgical debulking (two patients). Surgery was followed by concomitant chemoradiotherapy with hydroxyurea and 5-fluorouracil in a week-on, week-off sequence in 15 patients. One patient received standard radiation therapy. An additional three patients were treated with a sequence of surgical resection followed by concomitant chemoradiotherapy. The median total dose to the primary tumor was 60 Gy (range, 45-74 Gy). Results The overall survival at 5 and 10 years by lifetable analysis was 72.7% and 53.9%, respectively, and the disease-free survival at both 5 and 10 years was 66.6%. Local control was 76.1% at both 5 and 10 years. In the subgroup of patients treated with induction chemotherapy, 87% (14/16) achieved a clinical response. A complete response was confirmed at the time of surgery in five patients, whereas 11 patients had residual disease in the surgical specimen. Regional and distant failures were unusual (one patient each), with a 10-year regional control rate of 93% and a distant control rate of 95.5%. Serious, nonreversible long-term complications included two cases of unilateral blindness, one cataract, and one case of ototoxicity. Discussion An excellent long-term outcome with respect to local control, overall survival, and disease-free survival is achieved in locoregionally advanced Paranasal Sinus cancer treated with induction chemotherapy, surgery, and concomitant chemoradiotherapy. The 15 patients treated with this regimen had 10-year overall survival, disease-free survival, and local control rates of 56%, 73%, and 79%, respectively. These results are encouraging and are superior to the 40% survival achieved with surgery and radiation therapy. Further investigation of this regimen is warranted.

  • Locoregionally advanced Paranasal Sinus Carcinoma. Favorable survival with multimodality therapy.
    Archives of otolaryngology--head & neck surgery, 1993
    Co-Authors: Arie Rosen, Daniel J Haraf, Everett E. Vokes, Ralph R. Weichselbaum, Natan Scher, William R. Panje
    Abstract:

    • To determine the efficacy of multimodality treatment for stage III and IV, advanced Paranasal Carcinoma, we have retrospectively reviewed local control rate and disease-free survival in patients treated at the University of Chicago (III). Twelve consecutive patients with stage III or IV, newly diagnosed Paranasal Sinus Carcinoma treated between 1984 and 1991 were included in this study. Multimodality therapy was composed of a sequence of fluorouracil-cisplatin—based neoadjuvant chemotherapy (in 12 of 12 patients) followed by standard surgical resection (11 of 12 patients) and radiotherapy (12 of 12 patients, 45 to 73 Gy) with or without concomitant chemotherapy. Eleven patients (92%) are currently alive and free of disease, with a median follow-up of 55 months (range, 13 to 105 months). One patient died of persistent disease. Failure was attributed to incomplete surgical resection. There was only one major irreversible treatment complication (cisplatin ototoxic reaction). Our preliminary data suggest improved local control and survival with multimodality therapy that includes systemic neoadjuvant chemotherapy and standard tumor resection in patients with advanced Paranasal Sinus Carcinoma. These results are superior to the reported 40% survival with bimodal therapy and are better than those achieved in our institution for other head and neck primaries with the same treatment regimens. ( Arch Otolaryngol Head Neck Surg. 1993;119:743-746)

Everett E. Vokes - One of the best experts on this subject based on the ideXlab platform.

  • Multimodality therapy in advanced Paranasal Sinus Carcinoma: superior long-term results.
    The cancer journal from Scientific American, 1999
    Co-Authors: Everett E. Vokes, Arie Rosen, M E Witt, Ralph R. Weichselbaum, Daniel J Haraf
    Abstract:

    This study was conducted to determine the efficacy of multimodality treatment for stage III and IV, locoregionally advanced Paranasal Sinus Carcinoma. A subgroup analysis of 19 consecutive patients with stage III or IV Paranasal Sinus Carcinoma treated with multimodality therapy from head and neck cancer protocols between 1984 and 1996 were analyzed for outcome. Sixteen patients received induction chemotherapy consisting of three cycles of cisplatin and 5-fluorouracil, followed by traditional resection (14 patients) or surgical debulking (two patients). Surgery was followed by concomitant chemoradiotherapy with hydroxyurea and 5-fluorouracil in a week-on, week-off sequence in 15 patients. One patient received standard radiation therapy. An additional three patients were treated with a sequence of surgical resection followed by concomitant chemoradiotherapy. The median total dose to the primary tumor was 60 Gy (range, 45-74 Gy). The overall survival at 5 and 10 years by lifetable analysis was 72.7% and 53.9%, respectively, and the disease-free survival at both 5 and 10 years was 66.6%. Local control was 76.1% at both 5 and 10 years. In the subgroup of patients treated with induction chemotherapy, 87% (14/16) achieved a clinical response. A complete response was confirmed at the time of surgery in five patients, whereas 11 patients had residual disease in the surgical specimen. Regional and distant failures were unusual (one patient each), with a 10-year regional control rate of 93% and a distant control rate of 95.5%. Serious, nonreversible long-term complications included two cases of unilateral blindness, one cataract, and one case of ototoxicity. An excellent long-term outcome with respect to local control, overall survival, and disease-free survival is achieved in locoregionally advanced Paranasal Sinus cancer treated with induction chemotherapy, surgery, and concomitant chemoradiotherapy. The 15 patients treated with this regimen had 10-year overall survival, disease-free survival, and local control rates of 56%, 73%, and 79%, respectively. These results are encouraging and are superior to the 40% survival achieved with surgery and radiation therapy. Further investigation of this regimen is warranted.

  • Multimodality therapy in advanced Paranasal Sinus Carcinoma: superior long-term results.
    The cancer journal from Scientific American, 1999
    Co-Authors: M.m. Lee, M E Witt, Arie Rosen, Everett E. Vokes, Ralph R. Weichselbaum, Daniel J Haraf
    Abstract:

    Purpose This study was conducted to determine the efficacy of multimodality treatment for stage III and IV, locoregionally advanced Paranasal Sinus Carcinoma. Patients and methods A subgroup analysis of 19 consecutive patients with stage III or IV Paranasal Sinus Carcinoma treated with multimodality therapy from head and neck cancer protocols between 1984 and 1996 were analyzed for outcome. Sixteen patients received induction chemotherapy consisting of three cycles of cisplatin and 5-fluorouracil, followed by traditional resection (14 patients) or surgical debulking (two patients). Surgery was followed by concomitant chemoradiotherapy with hydroxyurea and 5-fluorouracil in a week-on, week-off sequence in 15 patients. One patient received standard radiation therapy. An additional three patients were treated with a sequence of surgical resection followed by concomitant chemoradiotherapy. The median total dose to the primary tumor was 60 Gy (range, 45-74 Gy). Results The overall survival at 5 and 10 years by lifetable analysis was 72.7% and 53.9%, respectively, and the disease-free survival at both 5 and 10 years was 66.6%. Local control was 76.1% at both 5 and 10 years. In the subgroup of patients treated with induction chemotherapy, 87% (14/16) achieved a clinical response. A complete response was confirmed at the time of surgery in five patients, whereas 11 patients had residual disease in the surgical specimen. Regional and distant failures were unusual (one patient each), with a 10-year regional control rate of 93% and a distant control rate of 95.5%. Serious, nonreversible long-term complications included two cases of unilateral blindness, one cataract, and one case of ototoxicity. Discussion An excellent long-term outcome with respect to local control, overall survival, and disease-free survival is achieved in locoregionally advanced Paranasal Sinus cancer treated with induction chemotherapy, surgery, and concomitant chemoradiotherapy. The 15 patients treated with this regimen had 10-year overall survival, disease-free survival, and local control rates of 56%, 73%, and 79%, respectively. These results are encouraging and are superior to the 40% survival achieved with surgery and radiation therapy. Further investigation of this regimen is warranted.

  • Locoregionally advanced Paranasal Sinus Carcinoma. Favorable survival with multimodality therapy.
    Archives of otolaryngology--head & neck surgery, 1993
    Co-Authors: Arie Rosen, Daniel J Haraf, Everett E. Vokes, Ralph R. Weichselbaum, Natan Scher, William R. Panje
    Abstract:

    • To determine the efficacy of multimodality treatment for stage III and IV, advanced Paranasal Carcinoma, we have retrospectively reviewed local control rate and disease-free survival in patients treated at the University of Chicago (III). Twelve consecutive patients with stage III or IV, newly diagnosed Paranasal Sinus Carcinoma treated between 1984 and 1991 were included in this study. Multimodality therapy was composed of a sequence of fluorouracil-cisplatin—based neoadjuvant chemotherapy (in 12 of 12 patients) followed by standard surgical resection (11 of 12 patients) and radiotherapy (12 of 12 patients, 45 to 73 Gy) with or without concomitant chemotherapy. Eleven patients (92%) are currently alive and free of disease, with a median follow-up of 55 months (range, 13 to 105 months). One patient died of persistent disease. Failure was attributed to incomplete surgical resection. There was only one major irreversible treatment complication (cisplatin ototoxic reaction). Our preliminary data suggest improved local control and survival with multimodality therapy that includes systemic neoadjuvant chemotherapy and standard tumor resection in patients with advanced Paranasal Sinus Carcinoma. These results are superior to the reported 40% survival with bimodal therapy and are better than those achieved in our institution for other head and neck primaries with the same treatment regimens. ( Arch Otolaryngol Head Neck Surg. 1993;119:743-746)

Michael Kaplan - One of the best experts on this subject based on the ideXlab platform.

  • Comparison of treatment plans using intensity-modulated radiotherapy and three-dimensional conformal radiotherapy for Paranasal Sinus Carcinoma
    International Journal of Radiation Oncology Biology Physics, 2003
    Co-Authors: David T. Huang, Clayton Akazawa, Pam Akazawa, Lynn J. Verhey, Jeanne M. Quivey, Michael Kaplan
    Abstract:

    Abstract Purpose To compare intensity-modulated radiotherapy (IMRT) treatment planning with three-dimensional conformal radiotherapy (3D-CRT) planning for Paranasal Sinus Carcinoma. Methods and materials Treatment plans using traditional 3-field technique, 3D-CRT planning, and inverse planning IMRT were developed for a case of Paranasal Sinus cancer requiring adjuvant radiotherapy. Plans were compared with respect to dose conformality, dose–volume histograms, doses to critical normal tissues, and ease of treatment delivery. Results The inverse-planned IMRT technique was more conformal around the tumor target volume than conventional techniques. The dose–volume histograms demonstrated significantly better critical normal-tissue sparing with the IMRT plans, while able to deliver a minimum dose of 60 Gy to the clinical tumor volume and 70 Gy to the gross tumor volume. Acute toxicities in our analysis were minimal. Conclusions IMRT planning provided improved tumor target coverage when compared to 3D-CRT treatment planning. There was significant sparing of optic structures and other normal tissues, including the brainstem. Inverse planning IMRT provided the best treatment for all Paranasal Sinus Carcinomas, but required stringent immobilization criteria. Further studies are needed to establish the true clinical advantage of this modality.