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Review
. 2021 May 1;33(3):196-205.
doi: 10.1097/CCO.0000000000000726.

Sinonasal cancers treatments: state of the art

Marco Ferrari  1 , Ester Orlandi  2 , Paolo Bossi  3
Affiliations
Review

Sinonasal cancers treatments: state of the art

Marco Ferrari et al. Curr Opin Oncol. .

Abstract

Purpose of review: The present review provides the reader with the state-of-the-art concepts of sinonasal oncology in view of the latest literature data.

Recent findings: Most recent publications in sinonasal oncology assessed treatment timing, centralization, surgical approach, margin status, orbit/neck management, salvage strategies, emerging surgical technologies, intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), particle radiotherapy, and neoadjuvant chemotherapy.

Summary: Indications to endoscopic surgery for sinonasal cancer have plateaued and are unlikely to further expand. Endoscopic surgery provides noninferior results compared to open surgery and best suits timing constraints imposed by multimodal treatment. Management of orbit-encroaching sinonasal cancer is remarkably improving mostly owing to optimal use of nonsurgical strategies. Prognostic value of the margin status and management of the nodal basin and recurrent sinonasal tumors are far from being fully elucidated. Most promising surgical technologies are surgical navigation, optical imaging, and radiofrequency-aided ablation. IMRT and VMAT have theoretical technical advantages that are in the process of being clinically demonstrated. Pieces of evidence are progressively confirming the physical and radiobiological advantages offered by particle radiotherapy. Systemic therapy is being tested mostly in the neoadjuvant setting with the aim of improving outcomes in locally advanced sinonasal cancers; response to induction chemotherapy could better select a further locoregional approach.

Trial registration: ClinicalTrials.gov NCT02998385.

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Conflict of interest statement

P.B. Advisory board or conference honoraria: Merck, Sanofi, Merck Sharp & Dohme, Sun Pharma, Angelini, Molteni, Bristol-Myers Squibb, Helsinn, GSK. M.F and E.O. do not have any conflicts of interest to declare.

Figures

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References

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    2. Data from a huge number of patients, witnessing the importance of maintaining time constraints for surgery and radiation also in sinonasal cancer management

    1. Xiao R, Joshi RR, Husain Q, et al. . Timing of surgery and adjuvant radiation therapy for sinonasal malignancies: effect of surgical approach. Head Neck 2019; 41:3551–3563. - PMC - PubMed

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