Ethmoid and upper nasal cavity carcinoma: treatment, results and complications

Nasal and paranasal sinus carcinoma: Are we making progress?

“…The close relation between survival and local control underscores the fact that the prognosis for patients with nasal and paranasal sinus carcinoma is related directly to local control of the disease. 4,5,103,117,154,157,174,186,196 In the literature, global results, most often expressed in terms of crude survival, vary between 10% 60,61,63,70,77,80,82,152 and 75%, 40,106,109,132,135,160,161,165,176 with better results in carefully selected patients, in patients with primary tumors of the nasal cavity, and in more recently published articles. The average over- all survival rate from the systematic review analysis was 41%, and the overall survival rate for the 1990s was 51%.…”

“…Several articles on patients who underwent craniofacial resection reported results as good as ours, but the results could not be included in the metaanalysis either because of large numbers of tumors with noncarcinoma histologies or because of a short followup. 8,9,46,[197][198][199] Nevertheless, several reports related outcomes better than ours for patients with squamous cell carcinoma, 48,56,106,100,110,117,132,137,147,160,168,176 for patients with glandular carcinoma, 160,168,184 and for patients with adenocarcinoma. 136,146 The systematic review revealed a steady improvement in treatment results for patients with squamous cell carcinoma and glandular carcinoma (Fig.…”

“…In general, patients with favorable lesions are found mainly in the surgery alone groups, whereas patients with large lesions and those who are treated for palliation are in the exclusive radiation or chemoradiation groups. Nevertheless, except for a few articles, 76,77,113,160,184 the results of radiation alone are poorer than treatments that include surgery. Furthermore, radical radiotherapy protocols have resulted in 20% 11 to 30% 56 unilateral blindness and 6% 11 to 10% 56 bilateral blindness.…”

Intensity-Modulated Radiotherapy for Sinonasal Cancer: Improved Outcome Compared to Conventional Radiotherapy

“…High doses of radiation are required to achieve lasting tumor control, even in the postoperative setting, but treatment planning is inevitably complicated by the proximity of critical OARs such as the eyes, optic nerves, optic chiasm, brainstem, and temporal lobes. Consequently, the outcome of conventional two-dimensional radiotherapy is suboptimal in terms of both disease control and radiation-induced morbidity (8,9,(11)(12)(13)(14)20). The introduction of CRT with 3D treatment planning on CT scans certainly signified an improvement, although 3D-CRT results remain unsatisfactory (10,(15)(16)(17)(18).…”

“…Nonetheless, the limitations of surgery alone are obvious given the frequent presentation of advanced disease. It has been clearly demonstrated that postoperative radiotherapy improves local control regardless of the surgical margin status (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). However, postoperative radiotherapy using conventional techniques is associated with a relatively high risk of potentially severe complications (21)(22)(23)(24)(25).…”