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Radiation Therapy for Nasal Cavity and Paranasal Sinus Cancers
Radiation therapy uses high-energy rays or particles to kill cancer cells. It’s an important part of treatment for many nasal cavity and paranasal sinus cancers.
When is radiation therapy used to treat nasal cavity or paranasal sinus cancers?
When treating nasal and paranasal sinus cancers, radiation might be used in many ways:
- As the main treatment for people with small nasal cavity tumors.
- As the main treatment for people who can't have surgery due to poor health or because the tumor is too advanced to remove with surgery.
- After surgery (adjuvant treatment) to try to kill any small areas of cancer that might be left behind. This is the most common use of radiation for these tumors.
- Before surgery (neoadjuvant treatment) to try to shrink the tumor so it's easier to remove.
- To treat lymph nodes in the neck if they’re enlarged or if the cancer is at higher risk of spreading to them.
- To help ease problems caused by the cancer, like pain, bleeding, and trouble swallowing when cancer spreads to areas beyond the head and neck. This is called palliative or supportive care.
- To treat cancer that has come back after treatment (recurrence).
For more advanced nasal cavity or paranasal sinus tumors, chemotherapy is often given along with the radiation. This is called chemoradiation. It usually works better than radiation alone, but it also has more side effects. It can be given before or after surgery, or alone as the main treatment in some cases. See Chemotherapy for Nasal Cavity and Paranasal Sinus Cancer for more details.
Treating nasal cavity and paranasal sinus cancers is complex, and it often requires careful coordination among different types of doctors. Studies have shown that people tend to have better outcomes when they get care at centers that treat a lot of head and neck cancers. Whenever possible, it’s important to get treatment at a cancer center that has experience in treating these cancers.
How is radiation therapy given for nasal cavity or paranasal sinus cancer?
External beam radiation therapy is the main type of radiation therapy used. It focuses a beam of radiation from a machine onto the cancer.
Before treatment
Before your treatments start, the radiation team will use a CT scan to take careful measurements to determine the correct angles for aiming the radiation beams and the proper dose of radiation.
A flexible but sturdy head and neck mask made of plastic mesh might be made to hold your head, neck, and shoulders in the exact same position for each treatment. You might also be fitted for a bite block that you hold in your mouth during treatment.
During treatment
Each treatment is much like getting an x-ray, although the radiation dose is stronger. The treatment itself is painless and typically lasts only a few minutes, although the process of getting you into place for treatment takes longer.
Radiation to the head and neck area can affect your teeth and gums. Before starting radiation treatments, you will be advised to see a dentist, who can make sure your mouth is healthy before treatment. They might even recommend that certain teeth be removed before you start radiation. During and after treatment, your dentist can help check for and treat any problems that might come up, such as infection or tooth and bone damage.
Radiation therapy schedules
In the standard radiation therapy schedule, treatment is given daily, 5 days a week for about 6 to 7 weeks.
Hyperfractionation refers to a slightly lower radiation dose that is given more than once a day. For example, it might be given twice a day for 7 weeks. This type of schedule is often used for these cancers.
Accelerated fractionation refers to the standard radiation dose being given each day but over a shorter total amount of time. For example, radiation might be given 6 days a week over 5 weeks instead of the standard 5 days a week for 7 weeks.
Advanced radiation therapy techniques
These tumors are close to many important structures in the head, including the eyes, brain, nerves, and blood vessels. Radiation can damage these structures, so doctors use advanced radiation therapy techniques to conform the beams to the shape of the tumor and limit the amount of radiation these structures get.
Examples of advanced radiation therapy techniques that might be used include:
- Intensity modulated radiation therapy (IMRT)
- Volumetric modulated arc therapy (VMAT)
- Helical tomotherapy
- Image-guided radiation therapy (IGRT)
- Proton beam radiation therapy
For more on these advanced radiation techniques, see Getting External Beam Radiation Therapy.
Possible side effects of radiation therapy
If you are going to get radiation therapy, it’s important to ask your doctor about the possible side effects so you know what to expect and can find ways to manage them.
Common side effects depend on where the radiation is aimed and can include:
- Skin problems in the area being treated, ranging from redness to blistering and peeling
- Nausea
- Loss of appetite
- Feeling tired or weak
- Trouble swallowing
- Hearing problems
- Dry eyes
- Dry mouth
- Hoarseness
- Change of taste
- Bone pain
- Bone damage
Most of these side effects go away slowly when treatment is over, but some might last longer. Side effects of radiation tend to be worse if chemotherapy is given at the same time. Tell your doctor about any side effects you have because there are often ways to lessen them.
Other side effects might include:
People treated with radiation to the head and neck area can get painful sores in the mouth and throat that can make eating and drinking hard. This can lead to weight loss and poor nutrition. Some people might need a feeding tube (called a gastrostomy tube or G-tube) during treatment to give them nutrition.
Mouth sores heal with time, but some people might continue to have problems swallowing even after treatment ends. Ask about swallowing exercises you can do to help keep those muscles working and increase your chance of eating normally after treatment.
Sometimes, radiation to the nasal cavity can cause it to get smaller or cause the tissues to stick together, which might make it harder to breathe through your nose. If this happens, your care team can teach you techniques to help open the tightened area so breathing is less of a problem.
Radiation aimed at the head and neck might damage the salivary (spit) glands, leading to dry mouth. This can cause discomfort and problems swallowing. It can also lead to tooth decay and damage to the jawbone.
People treated with radiation to the neck and throat need to pay close attention to their oral health and see their dentist regularly.
If the pituitary or thyroid glands are exposed to radiation, they might be damaged. Your doctor will do blood tests to see how well these glands are working. You might need to take medicine if there are problems.
Some people treated with radiation therapy to the neck area might be at risk of developing lymphedema in the face and neck. These areas can become swollen and firm. This can be worse if the person also had surgery. Sometimes medicines, physical therapy, or massage therapy might be helpful.
Radiation to the neck area might damage the carotid artery, which could increase your risk of stroke many years after treatment. This risk is higher in people with other health problems that might increase their risk, such as narrowing of the artery, plaques in the artery, or a history of smoking. Because of this, some doctors might schedule regular ultrasounds after treatment to keep an eye on your arteries.
More information about radiation therapy
To learn more about how radiation is used to treat cancer, see Radiation Therapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: February 27, 2026
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