Role of external radiotherapy in the treatment of Naso-sinus sarcomas

Naso-sinus sarcomas are uncommon and aggressive tumors with limited treatment options due to their proximity to vital structures. This retrospective study examines the effectiveness of external beam radiotherapy (EBRT), particularly intensity-modulated radiotherapy (IMRT), in managing these malignancies. Sixteen patients treated between 2013 and 2023 were analyzed, receiving radiation doses between 50 and 70 Gy. Additionally, 62.5% of patients with high-risk histologies underwent chemotherapy. Surgical resection was performed in 12.5% of cases. Most patients tolerated treatment well, experiencing only mild to moderate toxicities. Complete response was observed in 37.5% of cases, while 31.25% achieved partial response, and 18.75% had stable disease. Disease progression occurred in 12.5% of patients. Median disease-free survival was longer for those receiving chemotherapy (20 months) compared to those who did not (15 months). The overall median survival reached 24 months. These results underscore the importance of EBRT, particularly IMRT, in the multidisciplinary management of naso-sinus sarcomas. IMRT demonstrated improved local control with reduced toxicity. However, treatment remains complex, with potential late toxicities. Emerging radiotherapy techniques, such as proton therapy, volumetric-modulated arc therapy (VMAT), and stereotactic body radiotherapy (SBRT), may enhance outcomes. A collaborative, multidisciplinary approach is essential to optimize patient care.