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J Neurol Surg B Skull Base
DOI: 10.1055/s-0043-1774792
Original Article

Induction Chemotherapy for Sinonasal Tumors in Patients Presenting with Brain Invasion and/or Neurological Deficits

Bledi C. Brahimaj
1   Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Kevin J. Contrera 
2   Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Franco Rubino
1   Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Romulo Andrade de Almeida
1   Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Renata Ferrarotto
3   Department of Thoracic—Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Jack Phan
4   Department of Head and Neck Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Shirley Y. Su
2   Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Ehab Y. Hanna
2   Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Franco DeMonte
1   Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
,
Shaan M. Raza
1   Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Texas, United States
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Abstract

Objective The aim of this study was to investigate the safety of induction chemotherapy (IC) for patients with sinonasal malignancies with brain invasion or a neurological deficit.

Methods We conducted a retrospective analysis of patients who underwent IC for sinonasal malignancies with intracranial invasion or a neurological deficit at a single tertiary cancer center from 1992 to 2020.

Results In total, 460 patients with sinonasal malignancies were included in the study. Of the patients reviewed, 341 underwent IC and within this group 40 had brain invasion (BI) and 31 had a neurological deficit (ND) at presentation. The most prevalent malignancy was sinonasal undifferentiated carcinoma (BI 40%, ND 41.9%), followed by esthesioneuroblastoma (BI 27.5%, ND 9.7%). All tumors were stage T4 with the majority lacking nodal metastases (BI N0: 72.5%, ND N0: 77.5%). All patients completed at least two cycles of IC. Partial or complete response to IC was seen in 80% of BI and 71% of ND patients. No patients had cessation of treatment due to neurologic decline and none required urgent surgery. Five patients (12.5%) with BI and 2 (6.5%) with ND had interruption of IC for reasons other than neurological decline. In patients with ND, IC led to improvement of 54.5% NDs.

Conclusion In patients with sinonasal malignancies with BI or ND who underwent IC, no patients had cessation of treatment due to neurologic decline. In contrast, most patients had improvement of neurologic symptoms with IC. IC was safely administered without interruption due to neurological decline or symptom progression.

Keywords

induction chemotherapy - sinonasal - esthesioneuroblastoma - squamous cell carcinoma - sinonasal undifferentiated carcinoma - brain invasion - neurological deficits

Presentations

Podium presentation at the North American Skull Base Society Annual Meeting, Tampa Florida, United States, February 17, 2023.




Publication History

Received: 01 May 2023

Accepted: 17 August 2023

Article published online:
25 September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Levine PA, Frierson Jr HF, Stewart FM, Mills SE, Fechner RE, Cantrell RW. Sinonasal undifferentiated carcinoma: a distinctive and highly aggressive neoplasm. Laryngoscope 1987; 97 (8, Pt 1): 905-908
    CrossrefPubMedGoogle Scholar
  • 2 Dutta R, Dubal PM, Svider PF, Liu JK, Baredes S, Eloy JA. Sinonasal malignancies: a population-based analysis of site-specific incidence and survival. Laryngoscope 2015; 125 (11) 2491-2497
    CrossrefPubMedGoogle Scholar
  • 3 Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 2012; 34 (06) 877-885
    CrossrefPubMedGoogle Scholar
  • 4 König M, Osnes T, Bratland Å, Jebsen P, Meling TR. Treatment of sinonasal adenocarcinoma: a population-based prospective cohort study. J Neurol Surg B Skull Base 2020; 81 (06) 627-637
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Al-Mamgani A, van Rooij P, Mehilal R, Tans L, Levendag PC. Combined-modality treatment improved outcome in sinonasal undifferentiated carcinoma: single-institutional experience of 21 patients and review of the literature. Eur Arch Otorhinolaryngol 2013; 270 (01) 293-299
    CrossrefPubMedGoogle Scholar
  • 6 Mehta GU, Raza SM, Su SY, Hanna EY, DeMonte F. Management of olfactory neuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma involving the skullbase. J Neurooncol 2020; 150 (03) 367-375
    CrossrefPubMedGoogle Scholar
  • 7 Gamez ME, Lal D, Halyard MY. et al. Outcomes and patterns of failure for sinonasal undifferentiated carcinoma (SNUC): the Mayo Clinic experience. Head Neck 2017; 39 (09) 1819-1824
    CrossrefPubMedGoogle Scholar
  • 8 Paré A, Blanchard P, Rosellini S. et al. Outcomes of multimodal management for sinonasal squamous cell carcinoma. J Craniomaxillofac Surg 2017; 45 (08) 1124-1132
    CrossrefPubMedGoogle Scholar
  • 9 Chatelet F, Simon F, Bedarida V. et al. Surgical management of sinonasal cancers: a comprehensive review. Cancers (Basel) 2021; 13 (16) 3995
    CrossrefPubMedGoogle Scholar
  • 10 Thawani R, Kim MS, Arastu A. et al. The contemporary management of cancers of the sinonasal tract in adults. CA Cancer J Clin 2023; 73 (01) 72-112
    CrossrefPubMedGoogle Scholar
  • 11 Su SY, Bell D, Hanna EY. Esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma: differentiation in diagnosis and treatment. Int Arch Otorhinolaryngol 2014; 18 (Suppl. 02) S149-S156
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Abdelmeguid AS, Teeramatwanich W, Roberts DB. et al. Neoadjuvant chemotherapy for locoregionally advanced squamous cell carcinoma of the paranasal sinuses. Cancer 2021; 127 (11) 1788-1795
    CrossrefPubMedGoogle Scholar
  • 13 Amit M, Abdelmeguid AS, Watcherporn T. et al. Induction chemotherapy response as a guide for treatment optimization in sinonasal undifferentiated carcinoma. J Clin Oncol 2019; 37 (06) 504-512
    CrossrefPubMedGoogle Scholar
  • 14 Bartel R, Gonzalez-Compta X, Cisa E. et al. Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: series report and literature review. Acta Otorrinolaringol Esp (Engl Ed) 2018; 69 (04) 208-213
    CrossrefPubMedGoogle Scholar
  • 15 Aljumaily RM, Nystrom JS, Wein RO. Neoadjuvant chemotherapy in the setting of locally advanced olfactory neuroblastoma with intracranial extension. Rare Tumors 2011; 3 (01) e1
    CrossrefPubMedGoogle Scholar
  • 16 Loy AH, Reibel JF, Read PW. et al. Esthesioneuroblastoma: continued follow-up of a single institution's experience. Arch Otolaryngol Head Neck Surg 2006; 132 (02) 134-138
    CrossrefPubMedGoogle Scholar
  • 17 Hanna EY, Cardenas AD, DeMonte F. et al. Induction chemotherapy for advanced squamous cell carcinoma of the paranasal sinuses. Arch Otolaryngol Head Neck Surg 2011; 137 (01) 78-81
    CrossrefPubMedGoogle Scholar
  • 18 Mitchell EH, Diaz A, Yilmaz T. et al. Multimodality treatment for sinonasal neuroendocrine carcinoma. Head Neck 2012; 34 (10) 1372-1376
    CrossrefPubMedGoogle Scholar
  • 19 Yaniv D, Su SY. Updates in management strategies of locally advanced sinonasal malignancy. Curr Opin Otolaryngol Head Neck Surg 2023; 31 (01) 39-44
    CrossrefPubMedGoogle Scholar
  • 20 Kong KA, Thorp BD, Sheth SH. The role of induction therapy for sinonasal cancers. Curr Treat Options Oncol 2023; 24 (03) 162-169
    CrossrefPubMedGoogle Scholar
  • 21 London Jr NR, Mohyeldin A, Daoud G. et al. Sinonasal undifferentiated carcinoma: Institutional trend toward induction chemotherapy followed by definitive chemoradiation. Head Neck 2020; 42 (11) 3197-3205
    CrossrefPubMedGoogle Scholar
  • 22 Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010; 17 (06) 1471-1474
    CrossrefPubMedGoogle Scholar
  • 23 Common Terminology Criteria for Adverse Events (CTCAE). . Version 5. US Department of Health and Human Services. National Institutes of Health. National Cancer Institute. Published online November 27, 2017 at: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf
    PubMed
  • 24 Eisenhauer EA, Therasse P, Bogaerts J. et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45 (02) 228-247
    CrossrefPubMedGoogle Scholar
  • 25 Chambers KJ, Lehmann AE, Remenschneider A. et al. Incidence and survival patterns of sinonasal undifferentiated carcinoma in the United States. J Neurol Surg B Skull Base 2015; 76 (02) 94-100
    PubMedGoogle Scholar
  • 26 Lin EM, Sparano A, Spalding A. et al. Sinonasal undifferentiated carcinoma: a 13-year experience at a single institution. Skull Base 2010; 20 (02) 61-67
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 McElroy Jr EA, Buckner JC, Lewis JE. Chemotherapy for advanced esthesioneuroblastoma: the Mayo Clinic experience. Neurosurgery 1998; 42 (05) 1023-1027 , discussion 1027–1028
    CrossrefPubMedGoogle Scholar
  • 28 Wang J, Wang L, He H, Li Y, Song X. The treatment outcomes of olfactory neuroblastoma patients with frontal lobe invasion. Front Oncol 2021; 11: 640892
    CrossrefPubMedGoogle Scholar