INTRODUCTION: Malignancies of the nasal and paranasal sinuses are uncommon tumors, accounting for only 3% of all aerodigestive tract neoplasms. Despite advances in surgical techniques and continued evolution of adjuvant therapies, the 5-year mortality remains unusually high at greater than 50%. In 1996, we begin utilizing a novel strategy in the treatment of advanced sinonasal carcinomas. This consisted of neoadjuvant selective intra-arterial cisplatin with concurrent radiation therapy (acronym RADPLAT) followed by a conservative craniofacial resection. We now report our results for 11 patients treated with this regimen. METHODS: Between July 1996 and April 2003, 11 patients with advanced sinonasal malignancies underwent treatment utilizing the RADPLAT protocol followed by a planned surgical resection via a craniofacial approach. Patient charts, operative notes, follow-up clinic notes, and pre- and post-operative imaging studies were reviewed in detail for each subject. RESULTS: Histopathological analysis of the tumors revealed seven squamous cell carcinomas (64%), two adenocarcinomas (18%), one adenoid cystic carcinoma (9%), and one sinonasal undifferentiated carcinoma (9%). T4N0M0 disease was present in nine patients (81%), and two patients had T3N0M0 disease (19%). Survival was calculated using the Kaplan-Meier method with an overall survival of 81% at 5 years and a progression-free survival at 5 years of 67%. Mean follow-up is 57.2 months ranging from 12 to 95 months. CONCLUSIONS: The treatment of advanced sinonasal malignancies with pre-operative intra-arterial cisplatin and concurrent radiation results in a significant improvement in survival. This can be done safely with high response rates and excellent loco-regional control in T3 and T4 disease. Although are results are encouraging, there is a need for a cooperative, multi-institutional, prospective study.
INTRODUCTION:Malignancies of the nasal and paranasal sinuses are uncommon tumors, accounting for only 3% of all aerodigestive tract neoplasms. Despite advances in surgical techniques and continued evolution of adjuvant therapies, the 5-year mortality remains unusually high at greater than 50%. In 1996, we begin utilizing a novel strategy in the treatment of advanced sinonasal carcinomas. This consisted of neoadjuvant selective intra-arterial cisplatin with concurrent radiation therapy (acronym RADPLAT) followed by a conservative craniofacial resection. We now report our results for 11 patients treated with this regimen. METHODS: Between July 1996 and April 2003, 11 patients with advanced sinonasal malignancies underwent treatment utilizing the RADPLAT protocol followed by a planned surgical resection via a craniofacial approach. Patient charts, operative notes, follow-up clinic notes, and pre- and post-operative imaging studies were reviewed in detail for each subject. RESULTS: Histopathological analysis of the tumors revealed seven squamous cell carcinomas (64%), two adenocarcinomas (18%), one adenoid cystic carcinoma (9%), and one sinonasal undifferentiated carcinoma (9%). T4N0M0 disease was present in nine patients (81%), and two patients had T3N0M0 disease (19%). Survival was calculated using the Kaplan-Meier method with an overall survival of 81% at 5 years and a progression-free survival at 5 years of 67%. Mean follow-up is 57.2 months ranging from 12 to 95 months. CONCLUSIONS: The treatment of advanced sinonasal malignancies with pre-operative intra-arterial cisplatin and concurrent radiation results in a significant improvement in survival. This can be done safely with high response rates and excellent loco-regional control in T3 and T4 disease. Although are results are encouraging, there is a need for a cooperative, multi-institutional, prospective study.
Authors: K T Robbins; P Kumar; W F Regine; F S Wong; A B Weir; P Flick; L E Kun; R Palmer; T Murry; J Fontanesi; R Ferguson; R Thomas; W Hartsell; C U Paig; G Salazar; L Norfleet; C B Hanchett; V Harrington; H B Niell Journal: Int J Radiat Oncol Biol Phys Date: 1997-05-01 Impact factor: 7.038
Authors: K T Robbins; P Kumar; F S Wong; W F Hartsell; P Flick; R Palmer; A B Weir; H B Neill; T Murry; R Ferguson; C Hanchett; F Vieira; A Bush; S B Howell Journal: Head Neck Date: 2000-10 Impact factor: 3.147
Authors: Lester D R Thompson; Carla Penner; Ngoc J Ho; Robert D Foss; Markku Miettinen; Jacqueline A Wieneke; Christopher A Moskaluk; Edward B Stelow Journal: Head Neck Pathol Date: 2013-09-15
Authors: Matthias Kreppel; Sarah Danscheid; Martin Scheer; Jan Christoffer Lüers; Hans Theodor Eich; Joachim E Zöller; Orlando Guntinas-Lichius; Dirk Beutner Journal: Chemother Res Pract Date: 2012-09-29
Authors: J Yokoyama; S Ohba; M Fujimaki; T Anzai; M Kojima; K Ikeda; M Suzuki; H Yoshimoto; K Inoue Journal: Br J Cancer Date: 2014-09-25 Impact factor: 7.640