Impact of Socioeconomic Status on Paranasal Sinus Cancer Disease-Specific and Conditional Survival

Objective Socioeconomic status (SES) is often used to quantify social determinants of health. This study uses the National Cancer Institute SES index to examine the effect of SES on disease-specific survival and 5-year conditional disease-specific survival (CDSS; the change in life expectancy with increasing survivorship) in paranasal sinus cancer Study Design Cross-sectional analysis. Setting National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program. Methods A study of adults with sinus cancer between 1973 and 2015 was performed. The Yost index, a census tract–level composite score of SES, was used to categorize patients. Kaplan-Meier analysis and Cox regression for disease-specific survival were stratified by SES. CDSS was calculated with simplified models. Logistic regression was conducted to identify risk factors for advanced stage at diagnosis, multimodal therapy, and diagnosis of squamous cell carcinoma. Results There were 3437 patients analyzed. In Cox models adjusting for patient-specific factors, the lowest SES tertile exhibited worse mortality (hazard ratio, 1.22; 95% CI, 1.07-1.39; P < .01). After addition of treatment and pathology, SES was not significant ( P = .07). The lowest SES tertile was more often diagnosed at later stages (odds ratio [OR], 1.52; 95% CI, 1.12-2.06; P < .01). For those with regional/distant disease, the middle tertile (OR, 0.75; 95% CI, 0.63-0.90; P < .01) and lowest tertile (OR, 0.75; 95% CI, 0.62-0.91; P < .01) were less likely to receive multimodal therapy. SES tertiles primarily affected 5-year CDSS for regional/distant disease. CDSS for all stages converged over time. Conclusion Lower SES is associated with worse outcomes in paranasal sinus cancer. Research should be devoted toward understanding factors that contribute to such disparities, including tumor pathology and treatment course.

MODERN APPROACHES TO THE ORBITAL WALL RECONSTRUCTION WITH TITANIUM NICKELIDE IMPLANTS IN PATIENTS WITH NASAL CAVITY AND PARANASAL SINUS CANCER

Background. The majority of tumors of the nasal cavity and paranasal sinus are diagnosed at an advanced stage, requiring invasive and mutilating surgery, and therefore, the reconstruction of post-surgical craniofacial bone defects using various implants is necessary.Purpose of the study: to evaluate the effectiveness of the use of the thin-profile implants made of titanium nickelide in the surgical treatment of nasal cavity and paranasal sinus cancers.Material and Methods. From 2002 to 2020, a total of 60 patients with stage Т3–4n0–1M0 nasal cavity and paranasal sinus cancer were treated at the Cancer Research institute (tomsk). All patients received radiation therapy followed by surgery with reconstruction of bone structures of the subcranial region and orbital walls. In the study group (n=30), the orbital walls were restored with individual thin-profile shape memory titanium nickelide implants. In the control group (n=30), typical porous and tissue titanium nickelide implants were used. They required adjustment during surgery and complicated reparative processes in the postoperative period due to their thickness. Tissue implants did not allow accurate restoration of the orbital walls due to their structure.Results. Surgical rehabilitation with orbital wall reconstruction using thin-profile titanium nickelide implants makes it possible to shorten the duration of surgery and improve the precision of surgical repair. Features of the architectonics of implants do not interfere with the growth of tissues of the recipient zone, thus preventing the development of inflammation in the implantation site. The technique allows adequate restoration of the natural position and function of the eye.

Teknik 3D Conformal Radioterapi (3DCRT) Pada Keganasan Sinus Paranasal Dengan Modalitas Linac

Background: Radiotherapy is a radiation therapy action using ionizing radiation. To obtain the maximum dose of radiation in the tumour and the lowest possible dose on critical organs required a technique of radiation technique 3 Dimensional Conformal Radiotherapy (3DCRT). Radiotherapy Unit Radiology Installation Dr Sardjito Hospital Yogyakarta using 3DCRT technique. This research aims to know the radiotherapy procedure on paranasal sinus cancer using 3DCRT technique, to know the implementation of bolus beam modifier and dose optimization with the addition of electron radiation.Methods: The type of research in this thesis is qualitative research with case study approach. The research was conducted at Radiotherapy Unit Radiology Installation Dr Sardjito Hospital Yogyakarta after published Ethical Clearance. Methods of data collection in this study are observation, interviews, and documentation.Result: The results of this study indicate that the radiotherapy procedure in paranasal sinus cancer using 3DCRT technique can produce a homogeneous dose distribution, the implementation of bolus beam modifier is capable of generating dosage homogeneity on uneven target surfaces, and the distribution of doses with electron radiation on the target in the surface area can be optimal.Conclusion: With these techniques, the goal of radiotherapy can be achieved is to give the maximum dose in the tumour and the minimum dose possible in healthy tissue located in the vicinity.