Sinonasal Squamous Cell Carcinoma Survival Outcomes Following Induction Chemotherapy vs Standard of Care Therapy

Abstract

Objective To compare oncologic outcomes in sinonasal squamous cell carcinoma (SNSCC) treated with standard of care (SOC) definitive therapy, consisting of surgery or chemoradiotherapy, vs induction therapy followed by definitive therapy. Study Design Retrospective review. Setting Academic tertiary care hospital. Methods The medical records of patients with biopsy-proven SNSCC treated between 2000 and 2020 were reviewed for demographics, tumor characteristics, staging, treatment details, and oncologic outcomes. Patients were matched 1-to-1 by age, sex, and cancer stage according to treatment received. Time-to-event analyses were conducted. Results The analysis included 26 patients with locally advanced SNSCC who received either induction therapy (n = 13) or SOC (n = 13). Baseline demographics, Charlson Comorbidity Index, and median follow-up time were well balanced. Weekly cetuximab, carboplatin, and paclitaxel were the most common induction regimen utilized. Tolerance and safety to induction were excellent. Objective responses were observed in 11 of 13 patients receiving induction. No difference in disease-free survival was found between the induction and SOC groups at 1 or 3 years. However, when compared with SOC, induction therapy resulted in significant improvement in overall survival at 2 years (100% vs 65.3%, P = .043) and 3 years (100% vs 48.4%, P = .016) following completion of definitive therapy. Two patients in the SOC group developed metastatic disease, as compared with none in the induction group. Conclusions Induction therapy was safe and effective. When compared with SOC, induction therapy improved 3-year overall survival.

Analysis of Treatment Modalities for Advanced Stage Squamous Cell Carcinoma of the Maxillary Sinus: A National Cancer Database Study

“…19 Murr et al demonstrated 3-year OS improvement with induction chemotherapy. 20 Su et al found lower survival rates in radiotherapy and surgery groups compared with multimodality therapy. 21 Keerio et al compared modalities for maxillary SCC, finding adjuvant and neoadjuvant multimodal therapy yielded better outcomes.…”

“…Farrell et al (NCDB) showed induction chemotherapy followed by surgery improved OS compared to other approaches 17 . Murr et al demonstrated 3-year OS improvement with induction chemotherapy 18 . Su et al found lower survival rates in radiotherapy and surgery groups compared to multimodality therapy 19 .…”

Induction Chemotherapy for Locoregionally Advanced Sinonasal Squamous Cell Carcinoma

“…Several case series have investigated IC only in advanced SNSCC, finding an overall survival benefit when surgery was included as a potential definitive treatment. 23 Within these This article is protected by copyright. All rights reserved.…”

What is the Role of Induction Chemotherapy in the Treatment of Locally Advanced Sinonasal Squamous Cell Carcinoma?

“…These recommendations are based upon one systematic review 2 (level 2) and four retrospective cohort studies 1,3–5 (level 3).…”

“…Most recently, Murr et al performed a matched analysis of patients with locally advanced sinonasal SCC who received either IC or upfront definitive therapy with primary surgery or CRT. 5 IC included platins (100%) and taxanes (77%), with carboplatin + paclitaxel + cetuximab being the most common (62%) regimen. Overall, 85% responded to IC and 23% experienced adverse events, including neutropenia, type I hypersensitivity, and acute kidney injury.…”