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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1488066

Neoadjuvant chemotherapy followed by definitive local treatment in locally advanced sinonasal squamous cell carcinoma

Provisionally accepted
Jina Kim Jina Kim 1Min Hee Hong Min Hee Hong 1Hye Ryun Kim Hye Ryun Kim 1Sun Min Lim Sun Min Lim 1Chang Gon Kim Chang Gon Kim 1Da Hee Kim Da Hee Kim 2Nam Suk Sim Nam Suk Sim 2Hyun Jun Hong Hyun Jun Hong 2Yoon Woo Koh Yoon Woo Koh 2Se-Heon Kim Se-Heon Kim 2Chan Woo Wee Chan Woo Wee 1Chang Geol Lee Chang Geol Lee 1Ki Chang Keum Ki Chang Keum 1Chang-Hoon Kim Chang-Hoon Kim 2Kyung Hwan Kim Kyung Hwan Kim 1*
  • 1 Yonsei Cancer Center, College of Medicine, Yonsei University, Seoul, Republic of Korea
  • 2 College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Background: Sinonasal squamous cell carcinoma (SCC) is a rare disease entity, comprising less than 5% of malignancies of the head and neck. While surgery is the primary treatment approach, neoadjuvant and adjuvant therapies play crucial roles in enhancing the prognosis of patients undergoing treatment with the goal of cure. In this study, we aimed to explore the treatment outcomes of neoadjuvant chemotherapy (NAC) in patients with locally advanced sinonasal SCC. Methods: Medical records of patients diagnosed of locally advanced (cT3-4b, N0-3) sinonasal SCC treated with a definitive aim between January 2005 and March 2023 were retrospectively reviewed. Patients were categorized into the following groups based on the initial treatment: NAC followed by surgery, NAC followed by concurrent chemoradiotherapy (CCRT), definitive CCRT, or upfront surgery. Initial treatment plan was decided by a multidisciplinary team. Primary endpoint was overall survival (OS) and objective response rate, and secondary endpoints were progression free survival (PFS), cumulative incidence of local and distant failures, and treatment-related toxicity. The treatment response was assessed according to the RECIST criteria. Results: Total 126 patients were included, and the median follow-up period was 25.6 months. The objective response rate to NAC was 48.2%. The subsequent resection rate was 70%, 42.9%, and 16.7% for patients with stage T3, T4a, and T4b disease, respectively. Two-year progression-free survival did not differ significantly between the NAC followed by surgery and upfront surgery groups (53.6% vs. 60.6%, P = 0.615) or between the NAC followed by CCRT and definitive CCRT groups (26.7% vs. 37.4%, P = 0.506). Conclusion: NAC may be a valuable treatment option for patients with locally advanced sinonasal SCC, as it provides an opportunity for curative surgery and exhibits non-inferior oncological outcomes compared with upfront definitive local treatments.

    Keywords: sinonasal cancer, Neoadjuvant chemotherapy, concurrent chemoradiotherapy, Surgery, prognosis

    Received: 29 Aug 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Kim, Hong, Kim, Lim, Kim, Kim, Sim, Hong, Koh, Kim, Wee, Lee, Keum, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kyung Hwan Kim, Yonsei Cancer Center, College of Medicine, Yonsei University, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.