Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck Journal Article
| Authors: | Chen, A. M.; Daly, M. E.; El-Sayed, I.; Garcia, J.; Lee, N. Y.; Bucci, M. K.; Kaplan, M. J. |
| Article Title: | Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck |
| Abstract: | 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 the 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. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; clinical article; treatment outcome; treatment response; aged; middle aged; survival analysis; survival rate; treatment failure; retrospective studies; overall survival; cancer localization; postoperative period; fistula; treatment planning; cancer adjuvant therapy; cancer patient; cancer radiotherapy; disease free survival; chemotherapy, adjuvant; combined modality therapy; neoadjuvant therapy; radiotherapy, adjuvant; chemotherapy; follow up; follow-up studies; undifferentiated carcinoma; neoplasm recurrence, local; radiotherapy; survival time; head and neck cancer; tumors; medical record; carcinoma; remission induction; surgery; cataract; therapy effect; age distribution; cancer control; head and neck; paranasal sinus neoplasms; sinonasal; nose neoplasms; nose cavity; lacrimal duct occlusion; maxillary sinus; ethmoid sinus; sinocutaneous fistula; maxillary sinus neoplasms |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 70 |
| Issue: | 2 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-02-01 |
| Start Page: | 338 |
| End Page: | 343 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2007.06.057 |
| PUBMED: | 18207030 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 10" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
