Adult Rhabdomyosarcoma in the Nasal and Paranasal Sinuses Showing Complete Local Response to a Combination of Chemotherapy and Radiotherapy Using 3D-CRT and IMRT

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  • Muto Emi
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Shioyama Yoshiyuki
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Nakamura Katsumasa
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Ohga Saiji
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Nomoto Satoshi
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Toba Takashi
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Yoshitake Tadamasa
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Soeda Hiroyasu
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • Terashima Hiromi
    Department of Radiation Technology, School of Health Sciences, Faculty of Medicine, Kyushu University
  • Honda Hiroshi
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • 3D-CRT・IMRTを用いた放射線治療と化学療法の併用にて局所制御が得られた鼻腔・副鼻腔原発横紋筋肉腫の1例

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Description

We report on a 69-year-old woman with rhabdomyosarcoma arising from the nasal and paranasal sinuses. She was referred to our hospital with a reduced ability to smell and impaired bilateral vision, narrowing of the visual field, and left facial pain. Computed tomography (CT) revealed a large tumor in the nasal and left paranasal sinuses invading the left orbital cavity and anterior skull base, and lymph node swellings in the submental and left accessory nerve areas. A biopsy specimen from the nasal tumor was diagnosed histologically as a rhabdomyosarcoma, alveolar type. Because the intracranial direct invasion and distant metastases to the thoracic spine were suspected by pretreatment examination, our case was determined to be inoperable by a head and neck surgeon. Radiotherapy with a total dose of 60 Gy was carried out to control the primary disease. The three-dimensional conformal radiotherapy (3D-CRT) and intensitymodulated radiotherapy (IMRT) techniques were used in order to reduce the doses to risk organs. Combined with radiotherapy, chemotherapy was also performed for the treatment of lymph-node metastases and distant diseases. After the treatment was completed, the primary tumor and lymph-node metastases disappeared completely ; there was no sign of re-growth during the follow-up period. Chemoradiotherapy may be an effective treatment also for inoperable adult rhabdomyosarcoma in the head and neck region. Furthermore, the 3D-CRT and IMRT techniques are both useful methods of radiotherapy for this disease.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 96 (10), 363-369, 2005-10-25

    Fukuoka Medical Association

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