Locoregionally advanced paranasal sinus carcinoma. Favorable survival with multimodality therapy
A. Rosen, E. E. Vokes, N. Scher, D. Haraf, R. R. Weichselbaum and W. R. Panje
Section of Otolaryngology, Head and Neck Surgery, University of Chicago Medical Center.
To determine the efficacy of multimodality treatment for stage III and IV,
advanced paranasal carcinoma, we have retrospectively reviewed local
control rate and disease-free survival in patients treated at the
University of Chicago (Ill). Twelve consecutive patients with stage III or
IV, newly diagnosed paranasal sinus carcinoma treated between 1984 and 1991
were included in this study. Multimodality therapy was composed of a
sequence of fluorouracil-cisplatin-based neoadjuvant chemotherapy (in 12 of
12 patients) followed by standard surgical resection (11 of 12 patients)
and radiotherapy (12 of 12 patients, 45 to 73 Gy) with or without
concomitant chemotherapy. Eleven patients (92%) are currently alive and
free of disease, with a median follow-up of 55 months (range, 13 to 105
months). One patient died of persistent disease. Failure was attributed to
incomplete surgical resection. There was only one major irreversible
treatment complication (cisplatin ototoxic reaction). Our preliminary data
suggest improved local control and survival with multimodality therapy that
includes systemic neoadjuvant chemotherapy and standard tumor resection in
patients with advanced paranasal sinus carcinoma. These results are
superior to the reported 40% survival with bimodal therapy and are better
than those achieved in our institution for other head and neck primaries
with the same treatment regimens.
