title: Outcomes of nonsurgical management of locally advanced carcinomas of the sinonasal cavity.
abstract: To determine the outcome of definitive concurrent chemoradiation with platinum for locally advanced sinonasal carcinomas.
  
  
  
  Retrospective cohort.
  
  
  
  Twenty-three nonsurgically and definitively treated patients diagnosed between July 1998 and February 2009 were analyzed. Patients with adenoid cystic carcinoma or adenocarcinoma were treated with photons and neutrons; the other histologies received photons alone. The vast majority received chemotherapy. Descriptive statistics were utilized, and Kaplan-Meier estimates were computed.
  
  
  
  Female (57%) and Caucasian (74%) preponderance were observed. Eighty-seven percent were unresectable; the maxillary and nasoethmoid sites were equally prevalent. Intensity-modulated radiation therapy (IMRT) and photons alone were utilized in 74% and 70%, respectively. Platinum agents were given in 95% of chemotherapy patients. Complete response was observed in 64% of patients. Median progression-free survival (PFS) and overall survival (OS) were 28.8 and 65.3 months, respectively. Three-year PFS and OS rates were 44% and 72%, respectively; 5-year PFS and OS rates were 30% and 60%, respectively. Intensity-modulated radiation therapy and a maxillary site of origin showed a trend toward superior PFS; higher-dose regimens were associated with somewhat shorter PFS. Relapse was observed in 59% of patients, predominantly local. There were few unanticipated adverse effects, and no grade IV/V events were reported.
  
  
  
  Advanced sinonasal carcinomas are chemoradiosensitive tumors, albeit with a high propensity for local relapse. There is a definite indication for IMRT and a potential curative role of platinum-based chemoradiation regimens.
  
  
  
  4. Laryngoscope, 127:855-861, 2017.
authors.affiliation: Department of Head and Neck Surgery, Patel Super Specialty Hospital, Civil Lines, Jalandhar, Punjab, India.
authors.forename: Shamit
authors.initials: S
authors.lastname: Chopra
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Long Island Jewish School of Medicine, Long Island, New York.
authors.forename: Dev P
authors.initials: DP
authors.lastname: Kamdar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: David S
authors.initials: DS
authors.lastname: Cohen
authors.affiliation: Biostatistics Core, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: Lance K
authors.initials: LK
authors.lastname: Heilbrun
authors.affiliation: Biostatistics Core, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: Daryn
authors.initials: D
authors.lastname: Smith
authors.affiliation: Department of Radiation Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: Harold
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: Ho-Sheng
authors.initials: HS
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: John R
authors.initials: JR
authors.lastname: Jacobs
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: George
authors.initials: G
authors.lastname: Yoo
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D000072700:Conservative Treatment / Q000379:methods; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
keywords: Carcinoma; chemoradiation; cisplatin; sinonasal; unresectable