The Impact of Induction Chemotherapy and Socioeconomic Factors on Survival in Sinonasal Undifferentiated Carcinoma

Sinonasal undifferentiated carcinoma is a rare and aggressive tumor with an extremely poor prognosis. In the vast majority of cases, this tumor can not be resected due to its rapid local growth. Correct morphological diagnosis is impossible without a thorough differential diagnosis between sinonasal undifferentiated carcinoma and a number of lowgrade tumors of the nasal cavity and paranasal sinuses. Very few case reports and retrospective studies on sinonasal undifferentiated carcinoma have been published so far. No unified widely accepted guidelines on sinonasal undifferentiated carcinoma treatment are currently available due to the lack of statistically significant data from randomized clinical trials. The optimal treatment strategy should be based on an aggressive multimodal approach involving radical surgery, precision radiation therapy, and intensive chemotherapy. The benefits of systemic targeted therapy for patients with sinonasal undifferentiated carcinoma are still unclear. The best results can be achieved by employing tailored treatment approaches preferably in multidisciplinary cancer centers, where healthcare professionals experienced in managing patients with head and neck tumors can be involved. In this article, we report a case of complete radiological response after induction chemotherapy with docetaxel and doxorubicin and proton radiation therapy for the primary tumor area in a 53‑year-old female patient with non-resectable platinum-resistant sinonasal undifferentiated carcinoma.

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Identification of markers predictive for response to induction chemotherapy in patients with sinonasal undifferentiated carcinoma

Oral Oncology ◽

10.1016/j.oraloncology.2019.07.028 ◽

2019 ◽

Vol 97 ◽

pp. 56-61 ◽

Cited By ~ 1

Author(s):

Yoko Takahashi ◽

Frederico O. Gleber-Netto ◽

Diana Bell ◽

Dianna Roberts ◽

Tong-Xin Xie ◽

...

Keyword(s):

Induction Chemotherapy ◽

Undifferentiated Carcinoma ◽

Sinonasal Undifferentiated Carcinoma

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Induction Chemotherapy Response as a Guide for Treatment Optimization in Sinonasal Undifferentiated Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.18.00353 ◽

2019 ◽

Vol 37 (6) ◽

pp. 504-512 ◽

Cited By ~ 25

Author(s):

Moran Amit ◽

Ahmed S. Abdelmeguid ◽

Teemaranawich Watcherporn ◽

Hideaki Takahashi ◽

Samantha Tam ◽

...

Keyword(s):

Induction Chemotherapy ◽

Postoperative Radiotherapy ◽

Disease Free Survival ◽

Undifferentiated Carcinoma ◽

Locoregional Therapy ◽

Cancer Center ◽

Chemotherapy Response ◽

Sinonasal Undifferentiated Carcinoma ◽

Definitive Therapy ◽

Definitive Surgery

PURPOSE Multimodal therapy is a well-established approach for the treatment of sinonasal undifferentiated carcinoma (SNUC); however, the optimal sequence of the various treatments modalities is yet to be determined. This study aimed to assess the role of induction chemotherapy (IC) in guiding definitive therapy in patients with SNUC. METHODS Ninety-five previously untreated patients diagnosed with SNUC and treated between 2001 and 2018 at The University of Texas MD Anderson Cancer Center were included in the analysis. Patients were treated with curative intent and received IC before definitive locoregional therapy. The primary end point was disease-specific survival (DSS). Secondary end points included overall and disease-free survival, disease recurrence, and organ preservation. RESULTS A total of 95 treatment-naïve patients were included in the analysis. For the entire cohort, the 5-years DSS probability was 59% (95% CI, 53% to 66%). In patients who had partial or complete response to IC, the 5-year DSS probabilities were 81% (95% CI, 69% to 88%) after treatment with definitive concurrent chemoradiotherapy (CRT) after IC and 54% (95% CI, 44% to 61%) after definitive surgery and postoperative radiotherapy or CRT after IC (log-rank P = .001). In patients who did not experience at least a partial response to IC, the 5-year DSS probabilities were 0% (95% CI, 0% to 4%) in patients who were treated with concurrent CRT after IC and 39% (95% CI, 30% to 46%) in patients who were treated with surgery plus radiotherapy or CRT (adjusted hazard ratio of 5.68 [95% CI, 2.89 to 9.36]). CONCLUSION In patients who achieve a favorable response to IC, definitive CRT results in improved survival compared with those who undergo definitive surgery. In patients who do not achieve a favorable response to IC, surgery when feasible seems to provide a better chance of disease control and improved survival.

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