Impact of induction chemotherapy and socioeconomics on sinonasal undifferentiated carcinoma survival

Abstract

BackgroundSinonasal undifferentiated carcinoma (SNUC) is an uncommon malignancy of the nasal cavity and accessory sinuses with limited available studies evaluating role of induction chemotherapy (IC), demographics, and socioeconomic factors on overall survival (OS).MethodsThe 2004‐2015 National Cancer Database was queried for patients with histologically confirmed SNUC. IC was defined as chemotherapy administered 6 months to 2 weeks before surgery or ≥45 days before radiotherapy.ResultsOf 440 identified patients, 70 (16%) underwent treatments involving IC. This consisted of 52 (12%), 15 (3%), and 3 (1%) patients receiving IC before definitive radiation therapy, surgery and adjuvant radiotherapy, or surgery only, respectively. On univariate analysis, IC (p = 0.34) did not affect OS, whereas having government insurance (hazard ratio [HR], 1.79; 95% confidence interval [CI], 1.37‐2.34; p < 0.001) and living in regions with ≥13% of the population without a high school diploma (HR, 1.38; 95% CI, 1.06‐1.79; p = 0.02) were associated with worse OS. On log‐rank test, patients with advanced stage had similar OS regardless of whether or not they received IC (p = 0.96). Patients who received IC lived closer to their treatment site (p = 0.02) and had worse overall health, with more comorbidities (p = 0.02). The timing of IC before definitive surgery or radiation did not affect OS (p = 0.69).ConclusionIn this SNUC population‐based analysis, IC did not appear to provide additional OS benefit regardless of disease stage or timing before definitive treatment. Distance to treatment and level of comorbidities may be associated with receiving IC, whereas type of insurance and residence education level may impact SNUC OS, regardless of treatment.

Outcome for sinonasal malignancies: a population-based survey

“…However, only two patients received concomitant RT + CT and the other six RT (combined with surgery in two cases). This outcome corroborates findings by Lehrich et al, in a study involving 440 patients, indicating that induction chemotherapy may not provide survival benefits in SNUC patients [20]. As for many other subsets of SNM, further studies are warranted also for SNUC.…”

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

“…When treating head and neck cancers, radiotherapy is often employed, either alone or in combination with surgery [5][6][7][8]. In order to reduce normal tissue toxicity, the use of intensity-modulated radiotherapy has been implemented [9].…”

Outcomes of Endoscopic Versus Open Skull Base Surgery in Pediatric Patients

“…A large study on adult pituitary surgery outcomes using the national inpatient sample found that black patients and patients with Medicaid insurance were significantly more likely to have a postoperative complication compared to white patients and patients with private insurance 20 . Another study of patients with sinonasal undifferentiated carcinoma reported significantly worse overall survival outcomes in patients with government insurance or low education 21 . Based on these findings, as well as findings from other studies reported in head and neck oncology literature, 22–24 it is plausible that low socioeconomic status might drive the racial disparity observed in our sample.…”