Topical Application of 5-Fluorouracil for the Treatment of Sinonasal Adenocarcinoma and Inverted Papilloma.

IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY American Journal of Rhinology & Allergy Pub Date : 2024-09-01 Epub Date: 2024-06-07 DOI:10.1177/19458924241260118
Lucy Revercomb, Aman M Patel, Ivan Filimonov, David Lerner, Andrey Filimonov
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Abstract

Background: Sinonasal tumors represent a rare and heterogeneous group of rhinologic neoplasms. Even with advancements in surgical approaches, mortality rates of patients with sinonasal adenocarcinoma (SNAC) have not significantly improved and persistently high rates of recurrence in certain patients with inverted papilloma (IP) are seen. The use of 5-fluorouracil (5-FU) has been successfully described as an adjuvant treatment of SNAC and in the prevention of IP recurrence.

Objective: This review aims to present the current evidence on the management of SNAC and IP with topical 5-FU.

Methods: A three-author independent literature review was conducted to identify research involving the use of topical 5-FU for the treatment of SNAC and IP. A total of nine papers on the treatment of SNAC and IP were collected.

Results: The earliest study looking at the combination of adjuvant low-dose radiation and topical 5-FU for adenocarcinoma of the ethmoid sinus showed a 5-year survival rate of 100%. A follow-up study evaluating a similar protocol reported adjusted disease-free survival at 2, 5, and 10 years of 96%, 87%, and 74%, respectively. Similar results have been demonstrated for adjuvant 5-FU use following endoscopic resection and have even been described in the novel setting of transcutaneous 5-FU delivery following frontal trephination. Topical 5-FU has also been described in the treatment of aggressive IP. The largest case series described the use of 5-FU for eighteen cases and demonstrated only a single recurrence.

Conclusion: The use of topical 5-FU currently represents an underutilized therapeutic modality within the treatment of rhinologic neoplasms. Available literature suggests that neoadjuvant use of topical 5-FU can improve survival and decrease recurrence for SNAC and IP. However, the small sample sizes prevent advocation for routine use in the general population and further research on 5-FU is necessary.

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局部应用 5-氟尿嘧啶治疗鼻窦腺癌和倒置乳头状瘤。
背景:鼻窦肿瘤是一种罕见的异质性鼻科肿瘤。即使手术方法不断进步,鼻窦腺癌(SNAC)患者的死亡率也没有明显改善,某些倒置乳头状瘤(IP)患者的复发率一直居高不下。5-氟尿嘧啶(5-FU)作为鼻窦腺癌(SNAC)的辅助治疗和预防倒置乳头状瘤(IP)复发的药物已被成功应用:本综述旨在介绍目前使用 5-FU 局部治疗 SNAC 和 IP 的证据:方法:我们进行了一项由三位作者独立撰写的文献综述,以确定有关使用局部 5-FU 治疗 SNAC 和 IP 的研究。共收集到九篇关于治疗SNAC和IP的论文:最早对乙状窦腺癌联合使用低剂量放射线和局部 5-FU 辅助治疗的研究显示,5 年生存率为 100%。一项评估类似方案的后续研究报告显示,调整后的2年、5年和10年无病生存率分别为96%、87%和74%。内镜切除术后使用 5-FU 辅助治疗也取得了类似的效果,甚至在额部穿刺术后经皮下注射 5-FU 的新方法中也有类似的描述。外用 5-FU 也被用于治疗侵袭性 IP。最大的病例系列描述了 18 例使用 5-FU 的病例,结果显示只有一例复发:结论:目前,局部使用 5-FU 是治疗鼻腔肿瘤的一种未得到充分利用的治疗方式。现有文献表明,局部 5-FU 新辅助治疗可以提高鼻咽癌和鼻咽癌患者的生存率,降低复发率。然而,由于样本量较小,因此无法在普通人群中常规使用,有必要对 5-FU 进行进一步研究。
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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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