Neoadjuvant Chemoradiation in Squamous Cell Carcinoma of the Maxillary Sinus: A 26-Year Experience

Abstract

Background. The aim of our study was to evaluate the effects of neoadjuvant platinum-based radiochemotherapy (RCT) in patients with maxillary sinus squamous cell carcinoma and to compare the results with other multimodality treatment concepts for advanced-stage maxillary sinus carcinoma in the literature. Methods. In total, 53 patients with squamous cell carcinoma of the maxillary sinus were reviewed retrospectively. All patients received a neoadjuvant RCT containing either cisplatin or carboplatin followed by radical surgery. Overall survival and locoregional control were plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. Results. Five-year overall survival for all patients was 35%. Eleven patients achieved a complete response after radiochemotherapy. The complete response rate was significantly higher for patients treated with cisplatin (P = 0.028); however the 5-year overall survival rates did not differ significantly (P = 0.673) for patients treated with cisplatin (37%) and carboplatin (32%). Orbital invasion (P = 0.005) and complete response to radiochemotherapy (P = 0.021) had a significant impact on overall survival in univariate analysis. Conclusions. Neoadjuvant radiochemotherapy followed by radical surgery is an effective treatment for patients with advanced maxillary sinus squamous cell carcinoma. In terms of treatment response cisplatin seems to be more effective than carboplatin.

Clinical outcomes of sinonasal squamous cell carcinomas based on tumor etiology

“…Some groups have reported no significant difference in survival outcomes when comparing patients who underwent surgery plus adjuvant RT with patients who received definitive RT . Other investigators have also highlighted the benefit of neo‐adjuvant RT and CRT …”

Prognostic quality of the Union Internationale Contre le Cancer/American Joint Committee on Cancer TNM classification, 7th edition, for cancer of the maxillary sinus

“…This point highlights the weaknesses of the TNM classification: the TNM classification does not consider molecular characteristics that may predict response to neoadjuvant chemoradiation protocols and new molecular therapeutic approaches, such as targeted therapy . For advanced‐stage maxillary sinus cancer, however, multimodal treatment regimes containing neoadjuvant chemoradiation have proven to be effective . To incorporate therapeutic approaches other than surgery, the TNM system has to be stratified by therapy.…”

“…26 For advanced-stage maxillary sinus cancer, however, multimodal treatment regimes containing neoadjuvant chemoradiation have proven to be effective. 27,28 To incorporate therapeutic approaches other than surgery, the TNM system has to be stratified by therapy. This leads to an exponential increase in stage groups making it very difficult to evaluate the results because of the small number of patients in every stage group.…”

Correlation between ERCC1 expression and concurrent chemotherapy and radiotherapy in patients with locally advanced nasopharyngeal cancer

“…In recent years, clinical studies have demonstrated that radiotherapy combined with chemotherapy (Ang et al, 2010), especially based on single-agent cisplatin (Segawa et al, 2010;Kreppel et al, 2012) is superior to radiotherapy alone. However, because platinum drugs usually target DNA, differences in the ability to repair DNA are often the direct cause for the observed differences in sensitivity to platinum drugs among patients (Kiyohara et al, 2006).…”