Survival, efficacy and organ preservation outcomes of induction chemotherapy in sinonasal squamous cell carcinoma: a systematic review and meta-analysis

Abstract

Background: Locally advanced sinonasal squamous cell carcinoma (SNSCC) is typically treated with surgery, adjuvant radiation, and possibly chemotherapy, but the role of induction chemotherapy (ICT) has not been extensively studied.

Objective: The main objective was to assess the survival, efficacy, and organ preservation outcomes of ICT.

Material and methods: National Institute for Health and Care Excellence (NICE) search domain, PubMed, Embase, and Medline were queried for articles from inception through December 2024. A random-effects meta-analysis of pooled response, survival and orbital preservation rates were assessed.

Results: A total of 9 studies with 338 ICT patients were included. The pooled partial response (PR) rate was 57%. Complete response rates ranged from 2% to 17%, and stable response rates from 15% to 42%. Two-year overall survival was 78% (95% CI: 0.60-0.90) and disease-free survival was 93% (95% CI: 0.82-0.97). Orbital preservation rates were 83% (95% CI: 0.75-0.90).

Conclusions: Pooled evidence suggests that ICT may be an effective modality in producing PR for locally advanced SNSCC. However, high-quality trials with standardized regimens are needed to confirm its role.

Significance: This review provides the most updated statistical outcomes of ICT treatment in treating SNSCC which can help make decisions.

Keywords: Induction chemotherapy; concurrent chemoradiation; orbital invasion; orbital preservation; survival.