Multimodal Treatment With Orbital Organ Preservation in Adult Patients With Locally Advanced Small-Round-Cell Malignancy of the Nasal Cavity and Paranasal Sinus

Nanxiang Chen; Hu Yuan; Wenjun Fan; Lin Ma; Kun Liu; Lei Chen; Shiming Yang; Xinxin Zhang

doi:10.3389/fonc.2021.650385

Multimodal Treatment With Orbital Organ Preservation in Adult Patients With Locally Advanced Small-Round-Cell Malignancy of the Nasal Cavity and Paranasal Sinus

Front Oncol. 2021 Apr 1:11:650385. doi: 10.3389/fonc.2021.650385. eCollection 2021.

Authors

Nanxiang Chen¹, Hu Yuan¹, Wenjun Fan^{2

3

4}, Lin Ma⁵, Kun Liu¹, Lei Chen¹, Shiming Yang¹, Xinxin Zhang¹

Affiliations

¹ ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China.
² Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China.
³ Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁴ Department of Oncology, Armed Police Corps Hospital of Henan Province, Zhengzhou, China.
⁵ Department of Radiation Oncology, Chinese People's Liberation Army General Hospital, Beijing, China.

Abstract

Background: To investigate the efficacy of induction chemotherapy followed by concurrent chemotherapy and helical tomotherapy in adult patients with locally advanced small-round-cell malignancy of the nasal cavity and paranasal sinus in regard to orbital organ preservation and quality of life.

Methods: The clinical data of 49 patients with orbital involvement of locally advanced small-round-cell malignancy of the nasal cavity and paranasal sinus who received multimodal treatment for orbital organ preservation between December 2009 and January 2019 were retrospectively analyzed. Treatment efficacy and side effects were assessed. The study included three different pathological types. All patients were treated with induction chemotherapy followed by concurrent chemoradiotherapy. Helical tomotherapy was applied as radiotherapy. Adverse reactions to the chemotherapy were assessed according to Common Terminology Criteria for Adverse Events, Version 3. The overall survival (OS) rate, progression-free survival (PFS) rate, and orbital preservation rate were calculated using the Kaplan-Meier method.

Results: After multimodal treatment, the 3- and 5-year OS rates of the 49 patients were 63.8% and 54.5%, respectively, and the 3- and 5-year total PFS rates were 66.8% and 63.1%, respectively.

Conclusions: Multimodal treatment can preserve the orbital organs of adult patients with small-round-cell malignancy of the nasal cavity and paranasal sinus, achieve relatively ideal organ protection and survival rates, and improve quality of life, thus providing a new treatment option for these patients.

Keywords: helical tomotherapy; multimodal treatment; neuroendocrine carcinoma; olfactory neuroblastoma; orbital preservation; rhabdomyosarcoma; small-round-cell.