Premium
Outcomes of nonsurgical management of locally advanced carcinomas of the sinonasal cavity
Author(s) -
Chopra Shamit,
Kamdar Dev P.,
Cohen David S.,
Heilbrun Lance K.,
Smith Daryn,
Kim Harold,
Lin HoSheng,
Jacobs John R.,
Yoo George
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26228
Subject(s) - medicine , radiation therapy , adenoid cystic carcinoma , adenocarcinoma , retrospective cohort study , chemotherapy , cohort , progression free survival , carcinoma , radiology , oncology , surgery , cancer
Objective To determine the outcome of definitive concurrent chemoradiation with platinum for locally advanced sinonasal carcinomas. Study Design Retrospective cohort. Methods Twenty‐three nonsurgically and definitively treated patients diagnosed between July 1998 and February 2009 were analyzed. Patients with adenoid cystic carcinoma or adenocarcinoma were treated with photons and neutrons; the other histologies received photons alone. The vast majority received chemotherapy. Descriptive statistics were utilized, and Kaplan‐Meier estimates were computed. Results Female (57%) and Caucasian (74%) preponderance were observed. Eighty‐seven percent were unresectable; the maxillary and nasoethmoid sites were equally prevalent. Intensity‐modulated radiation therapy (IMRT) and photons alone were utilized in 74% and 70%, respectively. Platinum agents were given in 95% of chemotherapy patients. Complete response was observed in 64% of patients. Median progression‐free survival (PFS) and overall survival (OS) were 28.8 and 65.3 months, respectively. Three‐year PFS and OS rates were 44% and 72%, respectively; 5‐year PFS and OS rates were 30% and 60%, respectively. Intensity‐modulated radiation therapy and a maxillary site of origin showed a trend toward superior PFS; higher‐dose regimens were associated with somewhat shorter PFS. Relapse was observed in 59% of patients, predominantly local. There were few unanticipated adverse effects, and no grade IV/V events were reported. Conclusion Advanced sinonasal carcinomas are chemoradiosensitive tumors, albeit with a high propensity for local relapse. There is a definite indication for IMRT and a potential curative role of platinum‐based chemoradiation regimens. Level of Evidence 4. Laryngoscope , 127:855–861, 2017