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Neoadjuvant Chemotherapy in Locally Advanced and Borderline Resectable Nonsquamous Sinonasal Tumors (Esthesioneuroblastoma and Sinonasal Tumor with Neuroendocrine Differentiation)


Affiliations
1 Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
2 Department of Pathology, Tata Memorial Hospital, Mumbai, India
3 Department of Surgical oncology, Tata Memorial Hospital, Mumbai, India
4 Division of Clinical Research and Biostatistics, Malabar Cancer Centre, Kerala, India
 

Introduction: Sinonasal tumors are chemotherapy responsive which frequently present in advanced stages making NACT a promising option for improving resection and local control in borderline resectable and locally advanced tumours. Here we reviewed the results of 25 such cases treated with NACT. Materials and Methods: Sinonasal tumor patients treated with NACT were selected for this analysis. These patients received NACT with platinum and etoposide for 2 cycles. Patients who responded and were amenable for gross total resection underwent surgical resection and adjuvant CTRT. Those who responded but were not amenable for resection received radical CTRT. Patients who progressed on NACT received either radical CTRT or palliative radiotherapy. Results: The median age of the cohort was 42 years (IQR 37-47 years). Grades 3-4 toxicity with NACT were seen in 19 patients (76%).The response rate toNACT was 80%. Post-NACT surgery was done in 12 (48%) patients and radical chemoradiation in 9 (36%) patients. The 2-year progression free survival and overall survival were 75% and 78.5%, respectively. Conclusion: NACT in sinonasal tumours has a response rate of 80%. The protocol of NACT followed by local treatment is associated with improvement in outcomes as compared to our historical cohort.
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  • Neoadjuvant Chemotherapy in Locally Advanced and Borderline Resectable Nonsquamous Sinonasal Tumors (Esthesioneuroblastoma and Sinonasal Tumor with Neuroendocrine Differentiation)

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Authors

Vijay M. Patil
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Amit Joshi
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Vanita Noronha
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Vibhor Sharma
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Saurabh Zanwar
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Sachin Dhumal
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Shubhada Kane
Department of Pathology, Tata Memorial Hospital, Mumbai, India
Prathamesh Pai
Department of Surgical oncology, Tata Memorial Hospital, Mumbai, India
Anil D’Cruz
Department of Surgical oncology, Tata Memorial Hospital, Mumbai, India
Pankaj Chaturvedi
Department of Surgical oncology, Tata Memorial Hospital, Mumbai, India
Atanu Bhattacharjee
Division of Clinical Research and Biostatistics, Malabar Cancer Centre, Kerala, India
Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India

Abstract


Introduction: Sinonasal tumors are chemotherapy responsive which frequently present in advanced stages making NACT a promising option for improving resection and local control in borderline resectable and locally advanced tumours. Here we reviewed the results of 25 such cases treated with NACT. Materials and Methods: Sinonasal tumor patients treated with NACT were selected for this analysis. These patients received NACT with platinum and etoposide for 2 cycles. Patients who responded and were amenable for gross total resection underwent surgical resection and adjuvant CTRT. Those who responded but were not amenable for resection received radical CTRT. Patients who progressed on NACT received either radical CTRT or palliative radiotherapy. Results: The median age of the cohort was 42 years (IQR 37-47 years). Grades 3-4 toxicity with NACT were seen in 19 patients (76%).The response rate toNACT was 80%. Post-NACT surgery was done in 12 (48%) patients and radical chemoradiation in 9 (36%) patients. The 2-year progression free survival and overall survival were 75% and 78.5%, respectively. Conclusion: NACT in sinonasal tumours has a response rate of 80%. The protocol of NACT followed by local treatment is associated with improvement in outcomes as compared to our historical cohort.