Intra-arterial cisplatin and concomitant radiation therapy followed by surgery for advanced paranasal sinus cancer

Sandeep Samant, K. Thomas Robbins, M. Vang, Jim Wan, J. Robertson

Research output: Contribution to journalReview article

55 Citations (Scopus)

Abstract

Objective: To report the long-term efficacy of a combined regimen of intra-arterial high-dose cisplatin chemotherapy and concomitant radiation therapy followed by organ-sparing surgery when possible in the treatment of advanced paranasal sinus cancer. Design: Review of prospectively collected data. Setting: Academic referral center. Patients: Nineteen patients with advanced paranasal sinus malignancies with a minimum follow-up of 2 years. Malignancies included 14 squamous cell carcinomas (74%), 2 adenocarcinomas (10%), 2 adenoid cystic carcinomas (10%), and 1 undifferentiated carcinoma (5%). Sixteen patients (84%) had T4 disease. Intervention: Treatment consisted of preoperative radiation therapy (2.0 Gy/fraction per day; total dose, 50 Gy in 5 weeks) given concomitantly with 3 to 4 weekly infusions of intra-arterial cisplatin (150 mg/m2 per week) and systemic sodium thiosulfate neutralization. The regimen included planned surgery performed approximately 8 weeks after completion of radiation therapy. Ten patients underwent a transcranial anterior craniofacial resection; 1, a medial maxillectomy; and 1, an endoscopic restaging only. Results: After a median follow-up of 53 months, actuarial overall survival at 2 and 5 years was 68% and 53%, respectively. One patient died of myocardial infarction during treatment. No other treatment-limiting toxic effect was noted. Although 3 patients had persistence of disease, delayed local failure occurred only in 2 and distant metastasis in 3. Except for cataract in 2 patients, no visual loss developed. Conclusion: Despite the advanced stage and unfavorable nature of cancer in this cohort, our results indicate that this regimen holds promise and merits further study.

Original languageEnglish (US)
Pages (from-to)948-955
Number of pages8
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume130
Issue number8
DOIs
StatePublished - Aug 1 2004

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Paranasal Sinus Neoplasms
Cisplatin
Radiotherapy
Intra Arterial Infusions
Adenoid Cystic Carcinoma
Neoplasms
Paranasal Sinuses
Poisons
Therapeutics
Cataract
Squamous Cell Carcinoma
Adenocarcinoma
Referral and Consultation
Myocardial Infarction
Neoplasm Metastasis
Carcinoma
Drug Therapy
Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

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Intra-arterial cisplatin and concomitant radiation therapy followed by surgery for advanced paranasal sinus cancer. / Samant, Sandeep; Robbins, K. Thomas; Vang, M.; Wan, Jim; Robertson, J.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 130, No. 8, 01.08.2004, p. 948-955.

Research output: Contribution to journalReview article

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