The treatment of advanced juvenile nasopharyngeal angiofibroma

• Published in: International journal of radiation oncology, biology, physics Vol. 17; no. 5; pp. 1067 - 1072
• Main Authors: McGahan, Richard A., Durrance, Fred Y., Parke, Robert B., Easley, James D., Chou, J.Lillian
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.11.1989; Elsevier
• Subjects: Adolescent; Adult; Angiography, Digital Subtraction; Biological and medical sciences; Child; Histiocytoma, Benign Fibrous - blood supply; Histiocytoma, Benign Fibrous - diagnostic imaging; Histiocytoma, Benign Fibrous - radiotherapy; Humans; Intracranial extension; Juvenile nasopharyngeal angiofibroma; Magnetic Resonance Imaging; Male; Medical sciences; Nasopharyngeal Neoplasms - blood supply; Nasopharyngeal Neoplasms - diagnostic imaging; Nasopharyngeal Neoplasms - radiotherapy; Otorhinolaryngology. Stomatology; Radiation therapy; Tomography, X-Ray Computed; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Intracranial extension; Juvenile nasopharyngeal angiofibroma; Radiation therapy; Human; Nasopharynx; Treatment; Benign neoplasm
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(89)90157-0

Fifteen patients with juvenile nasopharyngeal angiofibroma (JNA) were treated in the Department of Radiation Oncology, Baylor College of Medicine between 1973 and 1986. All patients underwent radiographic evaluation including CT scanning, selective digital subtraction angiography, tomograms, or MRI. Patients referred for definitive irradiation exhibited extensive tumor involvement. Eleven of 15 patients had middle cranial fossa involvement; cavernous sinus extension was observed in six patients. Ten patients were treated with primary radiation therapy; five patients had surgical resection initially and were referred for radiation therapy upon local recurrence. Followup ranges from 1 1 2 –13 years. Four of the 5 patients who received 3200 cGy in 200 cGy fractions demonstrated tumor recurrence within 2 years after irradiation. All recurrences were ultimately controlled by either further irradiation and/or resection. No tumor recurrence was encountered among the patients treated at the higher tumor doses (36–46 Gy). No severe complications have been observed. Radiation therapy utilizing carefully tailored fields is an appropriate therapeutic approach to patients with extensive disease or intracranial extension. A total dose of greater than 40 Gy may allow improved local control for advanced lesions.