Korean J Intern Med.  2016 May;31(3):570-578. 10.3904/kjim.2015.020.

Induction chemotherapy in head and neck squamous cell carcinoma of the paranasal sinus and nasal cavity: a role in organ preservation

• Ock CY
• Keam B
• Kim TM
• Han DH
• Won TB
• Lee SH
• Hah JH
• Kwon TK
• Kim DW
• Kim DY
• Rhee CS
• Wu HG
• Sung MW
• Heo DS

• KMID: 2163514
• DOI: http://doi.org/10.3904/kjim.2015.020

Abstract

BACKGROUND/AIMS
The role of induction chemotherapy (IC) for eyeball preservation has not been established in head and neck squamous cell carcinoma (HNSCC) of the paranasal sinus and nasal cavity (PNSNC). Periorbital involvement frequently leads to eyeball exenteration with a margin of safety. We evaluated the treatment outcomes, including survival and eyeball preservation, of patients who received IC for HNSCC of the PNSNC.
METHODS
We reviewed 21 patients diagnosed with HNSCC of the PNSNC who were treated with IC. We analyzed response, eyeball preservation rate, and overall survival.
RESULTS
Tumors were located in the paranasal sinus (n = 14) or nasal cavity (n = 7). Most patients had stage T4a (n = 10) or T4b (n = 7) disease. More than half of the patients received a chemotherapy regimen of docetaxel, fluorouracil, and cisplatin (n = 11). Thirteen patients (61.9%) achieved a partial response after IC and 15 patients (71.4%) achieved T down-staging. Among 17 patients with stage T4 disease, which confers a high risk of orbital exenteration, 14 (82.4%) achieved preservation of the involved eye. The 3-year overall survival (OS) rate of patients who achieved a partial response to IC was 84.6%. The 3-year OS rate of patients with stable disease or disease progression after IC was 25.0% (p = 0.038).
CONCLUSIONS
IC could be considered for down-staging patients with advanced T-stage disease. It could also be a reasonable option for eyeball preservation in locally advanced HNSCC of the PNSNC.

Keyword

Induction chemotherapy; Head and neck neoplasms; Paranasal sinuses; Nasal cavity; Orbit evisceration

MeSH Terms

Carcinoma, Squamous Cell*
Cisplatin
Disease Progression
Drug Therapy
Fluorouracil
Head and Neck Neoplasms
Head*
Humans
Induction Chemotherapy*
Nasal Cavity*
Neck*
Orbit
Orbit Evisceration
Organ Preservation*
Paranasal Sinuses
Cisplatin
Fluorouracil