Reirradiation using proton therapy for the local recurrence of nasal cavity cancer; [Повторное облучение локального рецидива рака полости носа с применением протонной терапии]

Local recurrence after primary radiotherapy (RT) of nasal cavity tumors occurs in 18-40% of patients within the first 5 years after treatment. The primary treatment for recurrence is surgery, but in situations where surgery for some reason is not possible, chemotherapy and/or radiotherapy can be used. Chemotherapy as the only treatment does not always produces satisfactory results, as the response to therapy occurs in less than 40% of cases and the median survival rate is less than one year. After high radiation doses in primary treatment surrounding healthy tissues have very low or almost no tolerance left. As a result, complication of radiation therapy can become more frequent and it can lead to worse treatment outcomes and a reduction in the quality of life of patients. The unique depth-dose distribution of proton therapy allows to minimize damage to healthy tissues. This could potentially reduce the number of early and late radiation complications and improve tolerability. This article describes our own experience of using proton therapy as a reirradiation technique in a patient with a recurrent nasal tumor that developed six years after the primary treatment. This example shows that proton therapy can be successfully applied as a retreatment option in patients with recurrent nasal cavity tumors, which is one of the most challenging sites for radiation treatment planning. © 2023 Izdatel'stvo Meditsina. All rights reserved.