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Neoadjuvant chemotherapy followed by definitive local treatment in locally advanced sinonasal squamous cell carcinoma

Authors
 Jina Kim  ;  Min Hee Hong  ;  Hye Ryun Kim  ;  Sun Min Lim  ;  Chang Gon Kim  ;  Da Hee Kim  ;  Nam Suk Sim  ;  Hyun Jun Hong  ;  Yoon Woo Koh  ;  Se-Heon Kim  ;  Chan Woo Wee  ;  Chang Geol Lee  ;  Ki Chang Keum  ;  Chang-Hoon Kim  ;  Kyung Hwan Kim 
Citation
 FRONTIERS IN ONCOLOGY, Vol.14 : 1488066, 2024-10 
Journal Title
FRONTIERS IN ONCOLOGY
Issue Date
2024-10
Keywords
concurrent chemoradiotherapy ; neoadjuvant chemotherapy ; prognosis ; sinonasal cancer ; surgery
Abstract
Background: Sinonasal squamous cell carcinoma (SCC) is a rare disease entity, comprising less than 5% of malignancies of the head and neck. While surgery is the primary treatment approach, neoadjuvant and adjuvant therapies play crucial roles in enhancing the prognosis of patients undergoing treatment with the goal of cure. In this study, we aimed to explore the treatment outcomes of neoadjuvant chemotherapy (NAC) in patients with locally advanced sinonasal SCC.

Methods: Medical records of patients diagnosed of locally advanced (cT3-4b, N0-3) sinonasal SCC treated with a definitive aim between January 2005 and March 2023 were retrospectively reviewed. Patients were categorized into the following groups based on the initial treatment: NAC followed by surgery, NAC followed by concurrent chemoradiotherapy (CCRT), definitive CCRT, or upfront surgery. Initial treatment plan was decided by a multidisciplinary team. Primary endpoint was overall survival (OS) and objective response rate, and secondary endpoints were progression free survival (PFS), cumulative incidence of local and distant failures, and treatment-related toxicity. The treatment response was assessed according to the RECIST criteria.

Results: Total 126 patients were included, and the median follow-up period was 25.6 months. The objective response rate to NAC was 48.2%. The subsequent resection rate was 70%, 42.9%, and 16.7% for patients with stage T3, T4a, and T4b disease, respectively. Two-year progression-free survival did not differ significantly between the NAC followed by surgery and upfront surgery groups (53.6% vs. 60.6%, P = 0.615) or between the NAC followed by CCRT and definitive CCRT groups (26.7% vs. 37.4%, P = 0.506).

Conclusion: NAC may be a valuable treatment option for patients with locally advanced sinonasal SCC, as it provides an opportunity for curative surgery and exhibits non-inferior oncological outcomes compared with upfront definitive local treatments.
Files in This Item:
T202500283.pdf Download
DOI
10.3389/fonc.2024.1488066
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koh, Yoon Woo(고윤우)
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Kyung Hwan(김경환)
Kim, Da Hee(김다희) ORCID logo https://orcid.org/0000-0001-7286-1334
Kim, Se Heon(김세헌)
Kim, Chang Gon(김창곤)
Kim, Chang Hoon(김창훈) ORCID logo https://orcid.org/0000-0003-1238-6396
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Sim, Nam Suk(심남석)
Wee, Chan Woo(위찬우)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Lim, Sun Min(임선민)
Hong, Min Hee(홍민희) ORCID logo https://orcid.org/0000-0003-3490-2195
Hong, Hyun Jun(홍현준) ORCID logo https://orcid.org/0000-0002-7808-7877
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201678
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