Organ preservation with neoadjuvant chemoradiation in patients with orbit invasive sinonasal cancer otherwise requiring exenteration.
OBJECTIVE
We sought to determine if organ preservation (OP) with neoadjuvant chemoradiation (CRT) was feasible in patients with sinonasal cancer determined to require exenteration.


METHODS
Twenty patients were determined to require exenteration for definitive treatment from 2005 to 2014. Fourteen patients underwent OP and 6 patients received exenteration with adjuvant CRT. Exenteration free survival (EFS), locoregional control (LRC), progression-free survival (PFS), and overall survival (OS) were estimated.


RESULTS
Five patients (36%) receiving OP had complete disease response at time of surgery. With a median follow-up of 18.8 months, EFS was 62% at 2 years for patients undergoing OP. At 2 years, there were no significant differences in LRC, PFS or OS (all all p > 0.050) between the groups. Less grade 3 or greater toxicity was seen in patients undergoing OP (p = 0.003). Visual function was preserved in all patients undergoing OP.


CONCLUSIONS
For patients with sinonasal cancer, OP may avoid exenteration, offering similar disease control and improved toxicity.
Department of Radiation Oncology, University of Louisville, Louisville, KY, USA.
Mark J
MJ
Amsbaugh
Department of Radiation Oncology, University of Louisville, Louisville, KY, USA.
Mehran
M
Yusuf
Department of Radiation Oncology, University of Louisville, Louisville, KY, USA.
Craig
C
Silverman
Department of Otolaryngology, University of Louisville, Louisville, KY, USA.
Jeffrey
J
Bumpous
Department of Medicine, University of Louisville, Louisville, KY, USA.
Cesar A
CA
Perez
Department of Otolaryngology, University of Louisville, Louisville, KY, USA.
Keven
K
Potts
Department of Otolaryngology, University of Louisville, Louisville, KY, USA.
Paul
P
Tennant
Department of Medicine, University of Louisville, Louisville, KY, USA.
Rebecca
R
Redman
Department of Radiation Oncology, University of Louisville, Louisville, KY, USA.
Neal
N
Dunlap
Exenteration; Neoadjuvant; Orbit; Organ preservation; Sinonasal