Radiation Therapy

Abstract

Juvenile angiofibroma (JA) is a benign vascular tumor that develops almost entirely in young males. JA originates at the superior margin of the sphenoethmoidal suture which is located at the junction of the nasal cavity and nasopharynx, and JA is defined by its propensity for local invasion and bony destruction of the nasal cavity, nasopharynx, and skull base. No reports are available of nodal or distant metastasis. The preferred treatment for JA is selective embolization of the vascular supply of the tumor bed followed by surgical resection. For patients with extensive skull base invasion or intracranial extension, complete surgical resection may not be possible without accepting a high risk for severe acute and chronic complications. In these cases, we recommend definitive radiation therapy. Evidence supports the delivery of fractionated radiation therapy for JA tumors and reports suggest that the rate of local control ranges between 73 and 100 % following moderate doses of radiation therapy (36–45 Gy) (Amdur et al. Pract Radiat Oncol 1(4):271–278, 2011; Kuppersmith et al. Int J Pediatr Otorhinolaryngol 52(3):261–268, 2000; Lee et al. Laryngoscope 112(7 Pt 1):1213–1220, 2002; Mallick et al. Acta Otorhinolaryngol Ital 35(2):75–79, 2015; McGahan et al. Int J Radiat Oncol Biol Phys 17(5):1067–1072, 1989). Serious complications are uncommon; consequently, radiation therapy is an attractive alternative to surgery for patients with locally advanced disease.