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

• Published in: The Korean journal of internal medicine Vol. 31; no. 3; pp. 570 - 578
• Main Authors: Ock, Chan-Young, Keam, Bhumsuk, Kim, Tae Min, Han, Doo Hee, Won, Tae-Bin, Lee, Se-Hoon, Hah, J. Hun, Kwon, Tack-Kyun, Kim, Dong-Wan, Kim, Dong-Young, Rhee, Chae-Seo, Wu, Hong-Gyun, Sung, Myung-Whun, Heo, Dae Seog
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01.05.2016; 대한내과학회
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Disease Progression; Docetaxel; Eye; Female; Fluorouracil - administration & dosage; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Humans; Induction Chemotherapy - adverse effects; Induction Chemotherapy - methods; Kaplan-Meier Estimate; Male; Medical Records; Middle Aged; Nasal Cavity - drug effects; Nasal Cavity - pathology; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Staging; Nose Neoplasms - drug therapy; Nose Neoplasms - mortality; Nose Neoplasms - pathology; Organ Sparing Treatments - adverse effects; Organ Sparing Treatments - methods; Original; Paranasal Sinus Neoplasms - drug therapy; Paranasal Sinus Neoplasms - mortality; Paranasal Sinus Neoplasms - pathology; Proportional Hazards Models; Retrospective Studies; Risk Factors; Squamous Cell Carcinoma of Head and Neck; Survival Rate; Taxoids - administration & dosage; Time Factors; Treatment Outcome; Young Adult; 내과학; Induction chemotherapy; Orbit evisceration; Nasal cavity; Head and neck neoplasms; Paranasal sinuses
• ISSN: 1226-3303; 2005-6648; 2005-6648
• DOI: 10.3904/kjim.2015.020

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. We reviewed 21 patients diagnosed with HNSCC of the PNSNC who were treated with IC. We analyzed response, eyeball preservation rate, and overall survival. 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). 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.