Induction chemotherapy response as a guide to treatment optimisation in sinonasal undifferentiated carcinoma
In this aggressive nasal cancer, how the tumour responds to a first course of chemotherapy tells doctors which treatment to give next: chemoradiotherapy for responders, surgery for those who do not respond.
Overview
Retrospective study of 95 patients with sinonasal undifferentiated carcinoma treated at MD Anderson between 1988 and 2016, most with induction chemotherapy (platinum and etoposide or similar) followed by definitive treatment.
Among patients who responded to induction, definitive chemoradiotherapy gave better five-year disease-specific survival than surgery followed by radiotherapy (about 81 versus 54 percent); among non-responders, surgery followed by radiotherapy or chemoradiotherapy was better than chemoradiotherapy alone. Induction response now guides treatment selection at many centres.
- Five-year disease-specific survival about 81 percent with chemoradiotherapy versus 54 percent with surgery in induction responders.
- Non-responders did better with surgery followed by radiotherapy or chemoradiotherapy.
Sinonasal undifferentiated carcinoma is treated with induction platinum-etoposide, and the response decides whether the patient is spared radical surgery.
- Retrospective single-centre series over nearly thirty years.
- Response assessment was not standardised, and molecular subtypes (IDH2, SMARCB1) were not distinguished.
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