Proton Re-irradiation of Sinonasal Esthesioneuroblastoma: a Case report

Head and neck (H&N) cancers are in the 7-8th place among all types of cancer. Despite novel approaches in cancer treatment, most of the patients have a high risk of loco-regional recurrence. Esthesioneuroblastoma (ENB) is a very rare H&N neoplasm, accounting for only 3-6% of all intranasal tumors. These tumors usually are presented with locally advanced stages and required radiotherapy as a part of the comprehensive treatment. Locoregional failures represent a challenge, and re-irradiation can be effective for some groups of patients. We present a case of re-irradiation with protons of sinonasal tumor in a 49-years old patient with recurrent ENB, involving visual structures. We achieved a 5-year positive local control after the proton therapy (PT), without significant toxicity. The case shows an example of re-irradiation as an essential area for PT application, given the need to maximize the treatment's efficacy and minimize the risk of severe toxicity