Patterns of Failure After Combined-Modality Approaches Incorporating Radiotherapy for Sinonasal Undifferentiated Carcinoma of the Head and Neck

Journal Article · Fri Feb 01 04:00:00 EST 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.06.057· OSTI ID:21039737

Daly, Megan E ^[1]; El-Sayed, Ivan ^[2]; Garcia, Joaquin ^[3]; Lee, Nancy Y ^[4]; Bucci, M Kara ^[5]; Kaplan, Michael J ^[6]

---

1. Department of Radiation Oncology, University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA (United States)
2. Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA (United States)
3. Department of Pathology, University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA (United States)
4. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
5. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
6. Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA (United States)

Purpose: To report the clinical outcome of patients treated with combined-modality approaches for sinonasal undifferentiated carcinoma (SNUC) of the head and neck. Methods and Materials: The records of 21 patients with SNUC treated with curative intent at University of California, San Francisco between 1990 and 2004 were analyzed. Patient age ranged from 33 to 71 years (median, 47 years). Primary tumor sites included the nasal cavity (11 patients), maxillary sinus (5 patients), and ethmoid sinus (5 patients). All patients had T3 (4 patients) or T4 (17 patients) tumors. Local-regional treatment included surgery followed by postoperative radiotherapy (PORT) with or without adjuvant chemotherapy for 17 patients; neoadjuvant chemoradiotherapy followed by surgery for 2 patients; and definitive chemoradiotherapy for 2 patients. Median follow-up among surviving patients was 58 months (range, 12-70 months). Results: The 2- and 5-year estimates of local control were 60% and 56%, respectively. There was no difference in local control according to initial treatment approach, but among the 19 patients who underwent surgery the 5-year local control rate was 74% for those with gross tumor resection, compared with 24% for those with subtotal tumor resection (p = 0.001). The 5-year rates of overall and distant metastasis-free survival were 43% and 64%, respectively. Late complications included cataracts (2 patients), lacrimal stenosis (1 patient), and sino-cutaneous fistula (1 patient). Conclusion: The suboptimal outcomes suggest a need for more effective therapies. Gross total resection should be the goal of all treatments whenever possible.

• OSTI ID: 21039737
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 70; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CALIFORNIA
CARCINOMAS
CATARACTS
CHEMOTHERAPY
COMBINED THERAPY
METASTASES
NECK
NOSE
PATIENTS
RADIOTHERAPY
SINUSES
SURGERY