Long-term outcomes of modern multidisciplinary management of sinonasal cancers: The M. D. Anderson experience

Abstract

Purpose: To report long-term outcomes of modern radiotherapy for sinonasal cancers.

Methods and materials: A retrospective analysis of patients with sinonasal tumors treated with intensity-modulated radiotherapy or proton therapy. Multivariate analysis was used to determine predictive variables of progression free survival (PFS) and overall survival (OS).

Results: Three hundred and eleven patients were included, with median follow-up of 75 months. The most common histologies were squamous cell (42%), adenoid cystic (15%), and sinonasal undifferentiated carcinoma (15%). Induction chemotherapy was administered to 47% of patients; 68% had adjuvant radiotherapy. Ten-year local control, regional control, distant metastasis free survival, PFS, and overall survival rates were 73%, 88%, 47%, 32%, and 51%, respectively. Age, non-nasal cavity tumor site, T3-4 stage, neck dissection, and radiation dose were predictive of PFS, while age, non-nasal cavity tumor site, T3-4 stage, positive margins, neck dissection, and use of neoadjuvant chemotherapy were predictive of OS. There was a 13% rate of late grade ≥3 toxicities.

Conclusion: This cohort of patients with sinonasal cancer treated with modern radiotherapy demonstrates favorable disease control rate and acceptable toxicity profile.

Keywords: IMPT; IMRT; SCC; SNUC; VMAT; conformal radiotherapy; head and neck cancer; intensity modulated radiation therapy; paranasal sinus cancer; proton therapy; radiation therapy; radiotherapy; sinonasal tumors.