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Favorable Survival With Multimodality Therapy

Arie Rosen, MD; Everett E. Vokes, MD; Natan Scher, MD; Dan Haraf, MD; Ralph R. Weichselbaum, MD; William R. Panje, MD

Arch Otolaryngol Head Neck Surg. 1993;119(7):743-746.

Abstract
• 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 (III). 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.

(Arch Otolaryngol Head Neck Surg. 1993;119:743-746)

Author Affiliations
From the Section of Otolaryngology, Head and Neck Surgery (Drs Rosen, Scher, and Panje), the Department of Medicine, Section of Hematology-Oncology (Dr Vokes), and the Department of Radiation and Cellular Oncology (Drs Haraf and Weichselbaum), the University of Chicago (III) Medical Center. Dr Panje is now with Rush Medical College, Rush-Presbyterian-St Luke's Medical Center, Chicago.

Footnotes
Accepted for publication January 22, 1993.

Presented at the Third International Conference on Head and Neck Cancer, San Francisco, Calif, July 26, 1992.

Reprints not available.

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