title: Induction chemotherapy in technically unresectable locally advanced carcinoma of maxillary sinus.
abstract: Background. Locally advanced carcinoma of maxillary sinus has been historically reported to have poor prognosis. We evaluated the role of NACT in improving the outcome in these patients. Methods. 41 patients with locally advanced technically unresectable (stage IVa) or unresectable maxillary carcinoma (stage IVb) were treated with induction chemotherapy between 2008 and 2011. The demographic profile, response and toxicity of chemotherapy, definitive treatment received, progression free survival (PFS), and overall survival (OS) were analyzed. Univariate and multivariate analysis were performed to determine factors associated with PFS and OS. Results. The chemotherapy included two drugs (platinum and taxane) in 34 patients (82.9%) and three drugs (platinum, taxane, and 5 FU) in 7 (17.1%). There was no complete response seen in any of the patients, stable disease in 18 (43.9%), partial response in 16 (39%), and progression in 7 (17.1%) patients. After induction, the treatment planned included surgery in 12 (29.3%), CT-RT in 24 (58.5%), radical RT in 1 (2.4%), palliative RT in 1 (2.4%), and palliative chemotherapy in 3 (7.3%) patients. Overall, the median PFS was 10.0 months. The OS at 24 months and 36 months was 41% and 35%, respectively. Conclusion. In unresectable maxillary carcinoma, induction chemotherapy has clinically significant benefit with acceptable toxicity.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Vanita
authors.initials: V
authors.lastname: Noronha
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Vijay Maruti
authors.initials: VM
authors.lastname: Patil
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Joshi
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Muddu Vamshi
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authors.lastname: Krishna
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Sachin
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authors.lastname: Dhumal
authors.affiliation: Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India.
authors.forename: Shashikant
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authors.lastname: Juvekar
authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
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authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Pankaj
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authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Devendra Arvind
authors.initials: DA
authors.lastname: Chaukar
authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Jai Prakash
authors.initials: JP
authors.lastname: Agarwal
authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Sarbani
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Vedang
authors.initials: V
authors.lastname: Murthy
authors.affiliation: Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Anil
authors.initials: A
authors.lastname: D'cruz
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Kumar
authors.initials: K
authors.lastname: Prabhash