Nasal cavity reirradiation: a challenging case for comparison between proton therapy and volumetric modulated arc therapy

Tumori, 2016, 102 (Suppl. 2), S12-S15

Ruggieri R¹, Dionisi F², Mazzola R^1,3, Fellin F², Fiorentino A¹, Schwarz M², Ricchetti F¹, Amichetti M², Alongi F¹.

1    Department of Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar (Verona) - Italy.

2    Proton Therapy Unit, Department of Oncology, Azienda Provinciale per i Servizi Sanitari (APSS), Trento Italy.

3    Radiation Oncology School, Palermo - Italy.

BACKGROUND:

The aim of this case report is to report on a dosimetric comparison between volumetric modulated arc therapy (RapidArc technique and active scanning proton therapy (single-field (SFO) and multifield (MFO) techniques) in a case of nasal cavity cancer recurrence.

CASE REPORT:

A 72-year-old man, who received adjuvant radiotherapy for a carcinoma of the nasal cavity, experienced an unresectable local recurrence in the previous surgical bed. Hence, the patient was evaluated for reirradiation by comparing different modalities, with a total prescribed dose of 50 Gy in standard fractionation. RA plan was revealed to be equivalent to the MFO plan in terms of target dose coverage and conformity index. SFO plan was not able to respect a maximum dose of 9 Gy to nervous structures, in contrast to RA and MFO plans.

CONCLUSIONS:

In this challenging scenario, although a clear preference would be given to the MFO proton plan, the RA plan was revealed to be adequate for the clinical goal of target coverage and sparing of organs at risk.