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Carcinoma of the nasal cavity and paranasal sinuses
The Laryngoscope, 04/10/09

Mendenhall WM et al. - In a study to determine the outcomes after radiotherapy (RT) alone or combined with surgery for pts with carcinomas of the nasal cavity and paranasal sinuses, it seems that the probability of local control and cause-specific survival is better after surgery and RT compared with definitive RT. There is a modest increase in risk of complications after surgery and RT. The preferred treatment is surgery combined with preoperative or postoperative RT.

Methods

109 pts were treated with curative intent.
Pts with maxillary sinus carcinomas were excluded.
56 pts were treated with definitive RT, and 53 pts received surgery and preoperative (8 pts) or postoperative (45 pts) RT.
Median follow-up was 4.3 yrs.
Median follow-up on living pts was 9.4 yrs.

Results

5-yr local control rates were: T1-T3, 82%; T4, 50%; and overall, 63%.
Local control at 5 yrs was 43% after definitive RT vs 84% after surgery and adjuvant RT.
Multivariate analysis of local control revealed that both overall stage and treatment group significantly impacted this endpoint.
Cause-specific survival rates were: stages I to III, 81%; stage IV, 54%; and overall, 62%.
Multivariate analysis revealed that T-stage, N-stage, and treatment group significantly influenced this endpoint.
31 (20%) of 109 pts sustained severe complications; 17 of 56 pts (16%) after definitive RT and 14 of 53 pts (25%) after surgery and adjuvant RT.

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