Fig. 1
From: Rare entities in head-and-neck cancer: salvage re-irradiation with carbon ions
Shown are treatment and follow-up images of a 54 year old male patient with a recurrent small cell neuroendocrine carcinoma of the left paranasal sinus. After initial radiation treatment (66 Gy in 2 Gy fractions intensity-modulated radiation therapy) and three cycles of carboplatin and etoposide, the patient received re-irradiation with carbon ions (51 Gy (RBE) in 17 fractions) to the left paranasal sinus. The treatment planning T1 contrast-enhanced fat-suppressed magnetic resonance imaging (MRI) and the corresponding carbon ion treatment plan are shown in (a) and (b), respectively. The recurrent tumor was stable 24 months after treatment (c). Another 6 months later (30 months post-treatment), a recurrence developed in the contralateral paranasal sinus, shown as a T2w-hypointense tumor in the follow-up MRI (d)