Results of complex treatment of patients with locally advanced squamous cell carcinoma of the paranasal sinuses and nasal cavity using induction chemotherapy

T.  . Dеshkina, L. Bolotina, A. Gevorkov, A. Boyko, A. Kornietskaya, A. Polyakov, P. Golubev, R.  S. Sydykova, A. Fedenko
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Abstract

Introduction. About 600 new cases of malignant neoplasms of the paranasal sinuses and nasal cavity are detected annually in Russia. To date, there are no randomized trials to determine the optimal treatment algorithm for this group of patients. Data on the use of induction chemotherapy in squamous cell carcinoma of sino-nasal tract are limited to a small series of clinical observations and, often, are retrospective in nature.Aim. Evaluation of the effectiveness of induction chemotherapy in patients with locally advanced squamous cell carcinoma of the paranasal sinuses and nasal cavity.Materials and methods. Since 2012, 22 patients with locally advanced cancer of the paranasal sinuses and nasal cavity have been treated in our center, who underwent 3-component induction chemotherapy according to the TPF protocol. Evaluation of the effectiveness of treatment was carried out according to the criteria of Response evaluation criteria in solid tumors 1.1 (RECIST 1.1). Patients with a decrease in the tumor size by 30 % or more, were followed by radiation therapy in doses of 66–70 Gy. Patients with a residual tumor underwent surgery after the end of chemoradiotherapy.Results. In 21 patients available for analysis, overall response rate after induction chemotherapy was 71 %: complete response was registered in 3 (14 %) patients, partial response in 12 (57 %), stable disease in 4 (19 %). Progression disease after 3 courses of induction chemotherapy was detected in 2 (10 %) patients.Conclusions. Thus, induction chemotherapy in patients with squamous cell carcinoma of sino-nasal tractseems to be a promising direction for investigation, that can significantly improve the long-term results of treatment of this category of patients and help to avoid of disabling surgery in some of them.
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诱导化疗综合治疗局部晚期鼻窦及鼻腔鳞状细胞癌的结果
介绍。在俄罗斯,每年约有600例新的副鼻窦和鼻腔恶性肿瘤被发现。到目前为止,还没有随机试验来确定这组患者的最佳治疗算法。诱导化疗用于鼻道鳞状细胞癌的数据仅限于一小部分临床观察,而且通常是回顾性的。鼻窦及鼻腔局部晚期鳞状细胞癌诱导化疗的疗效评价。材料和方法。2012年以来,我中心共收治了22例局部中晚期鼻窦、鼻腔癌患者,均按照TPF方案进行了三组份诱导化疗。根据实体瘤应答评价标准1.1 (RECIST 1.1)进行疗效评价。肿瘤缩小30%或更多的患者随后接受66-70 Gy剂量的放射治疗。放化疗结束后,残余肿瘤患者行手术治疗。在21例可用于分析的患者中,诱导化疗后的总缓解率为71%:完全缓解3例(14%),部分缓解12例(57%),病情稳定4例(19%)。2例(10%)患者在诱导化疗3个疗程后出现疾病进展。因此,诱导化疗在鼻鼻道鳞状细胞癌患者中的应用似乎是一个很有前景的研究方向,可以显著提高该类患者的远期治疗效果,并有助于避免部分患者的致残性手术。
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