Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T03:08:36.116Z Has data issue: false hasContentIssue false
  • English
  • Français

A multimodality approach to sinonasal undifferentiated carcinoma: a single institute experience

Published online by Cambridge University Press:  12 December 2016

S Bhasker ,
S Mallick ,
R Benson ,
V Bhanuprasad ,
A Sharma  and
A Thakar
S Bhasker
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
S Mallick*
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
R Benson
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
V Bhanuprasad
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
A Sharma
Affiliation:
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
A Thakar
Affiliation:
Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
*
Address for correspondence: Dr S Mallick, Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India Fax: +91 11 26589243 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Sinonasal undifferentiated carcinoma is a rare aggressive tumour arising from the Schneiderian epithelium lining the sinonasal tract. Although considered the cornerstone of therapy, surgical resection can only be performed in a limited number of patients. This report describes the experience of treating sinonasal undifferentiated carcinoma with a multimodality approach.

Method:

The treatment charts of sinonasal undifferentiated carcinoma patients treated at a tertiary care centre from 2004 to 2012 were retrospectively reviewed.

Results:

A total of 16 sinonasal undifferentiated carcinoma patients with a median age at diagnosis of 47.5 years (range 8–65 years) were included: 19 per cent had neck nodal metastasis at presentation. Four patients (25 per cent) underwent surgery: of these, two had post-operative radiotherapy, one had pre-operative radiotherapy and one had adjuvant chemotherapy alone. Six patients (38 per cent) received definitive radiotherapy: five had received neoadjuvant chemotherapy to reduce tumour size and help in radiotherapy planning, while four (25 per cent) received palliative radiotherapy. The median follow up was 10.4 months (range 1–42.5 months). The estimated median progression-free survival time was 29.3 months. One- and three-year progression-free survival rates were 77 per cent and 41 per cent, respectively.

Conclusion:

Surgery is the best treatment option for sinonasal undifferentiated carcinoma, although most patients require post-operative radiotherapy for advanced disease and close tumour margins. Definitive radiotherapy with or without chemotherapy may be suitable for patients with inoperable locally advanced disease. Elective nodal irradiation to address the high nodal involvement rates should be considered to improve the survival rate.

Keywords

Maxillary Sinus NeoplasmsRadiotherapyDrug TherapyChemotherapyAdjuvant
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 1 , January 2017 , pp. 19 - 25
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Frierson, HF, Mills, SE, Fechner, RE, Taxy, JB, Levine, PA. Sinonasal undifferentiated carcinoma. An aggressive neoplasm derived from schneiderian epithelium and distinct from olfactory neuroblastoma. Am J Surg Pathol 1986;10:771–9Google ScholarPubMed
2 Chen, AM, Daly, ME, El-Sayed, I, Garcia, J, Lee, NY, Bucci, MK et al. Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 2008;70:338–43CrossRefGoogle ScholarPubMed
3 Wadsworth, B, Bumpous, JM, Martin, AW, Nowacki, MR, Jenson, AB, Farghaly, H. Expression of p16 in sinonasal undifferentiated carcinoma (SNUC) without associated human papillomavirus (HPV). Head Neck Pathol 2011;5:349–54Google Scholar
4 Lin, EM, Sparano, A, Spalding, A, Eisbruch, A, Worden, FP, Heth, J et al. Sinonasal undifferentiated carcinoma: a 13-year experience at a single institution. Skull Base 2010;20:61–7Google Scholar
5 Xu, CC, Dziegielewski, PT, McGaw, WT, Seikaly, H. Sinonasal undifferentiated carcinoma (SNUC): the Alberta experience and literature review. J Otolaryngol Head Neck Surg 2013;42:2 Google Scholar
6 Rosenthal, DI, Barker, JL, El-Naggar, AK, Glisson, BS, Kies, MS, Diaz, EM et al. Sinonasal malignancies with neuroendocrine differentiation: patterns of failure according to histologic phenotype. Cancer 2004;101:2567–73CrossRefGoogle ScholarPubMed
7 Radiation Therapy Oncology Group: Acute Radiation Morbidity Scoring Criteria. In: http://www.rtog.org/researchassociates/adverseeventreporting/acuteradiationmorbidityscoringcriteria.aspx [14 September 2016]Google Scholar
8 Revenaugh, PC, Seth, R, Pavlovich, JB, Knott, PD, Batra, PS. Minimally invasive endoscopic resection of sinonasal undifferentiated carcinoma. Am J Otolaryngol 2011;32:464–9Google Scholar
9 Mourad, WF, Hauerstock, D, Shourbaji, RA, Hu, KS, Culliney, B, Li, Z et al. Trimodality management of sinonasal undifferentiated carcinoma and review of the literature. Am J Clin Oncol 2013;36:584–8Google Scholar
10 Pitman, KT, Costantino, PD, Lassen, LF. Sinonasal undifferentiated carcinoma: current trends in treatment. Skull Base Surg 1995;5:269–72CrossRefGoogle ScholarPubMed
11 Musy, PY, Reibel, JF, Levine, PA. Sinonasal undifferentiated carcinoma: the search for a better outcome. Laryngoscope 2002;112:1450–5Google Scholar
12 Singh, L, Ranjan, R, Arava, S, Singh, MK. Role of p40 and cytokeratin 5/6 in the differential diagnosis of sinonasal undifferentiated carcinoma. Ann Diagn Pathol 2014;18:261–5Google Scholar
13 Reiersen, DA, Pahilan, ME, Devaiah, AK. Meta-analysis of treatment outcomes for sinonasal undifferentiated carcinoma. Otolaryngol Head Neck Surg 2012;147:7–14 Google Scholar
14 Rischin, D, Porceddu, S, Peters, L, Martin, J, Corry, J, Weih, L. Promising results with chemoradiation in patients with sinonasal undifferentiated carcinoma. Head Neck 2004;26:435–41Google Scholar
15 Tanzler, ED, Morris, CG, Orlando, CA, Werning, JW, Mendenhall, WM. Management of sinonasal undifferentiated carcinoma. Head Neck 2008;30:595–9Google Scholar
16 Yoshida, E, Aouad, R, Fragoso, R, Farwell, DG, Gandour-Edwards, R, Donald, PJ et al. Improved clinical outcomes with multi-modality therapy for sinonasal undifferentiated carcinoma of the head and neck. Am J Otolaryngol 2013;34:658–63Google Scholar
17 Christopherson, K, Werning, JW, Malyapa, RS, Morris, CG, Mendenhall, WM. Radiotherapy for sinonasal undifferentiated carcinoma. Am J Otolaryngol 2014;35:141–6CrossRefGoogle ScholarPubMed