The role of systemic therapy in the management of sinonasal cancer: A critical review

Paolo Bossi, Nabil F. Saba, Jan B. Vermorken, Primoz Strojan, Laura Pala, Remco De Bree, Juan Pablo Rodrigo, Fernando Lopez, Ehab Y. Hanna, Missak Haigentz, Robert P. Takes, Piet J. Slootweg, Carl E. Silver, Alessandra Rinaldo, Alfio Ferlito

Research output: Contribution to journalReview articlepeer-review

98 Scopus citations


Purpose: Due to the rarity and the variety of histological types of sinonasal cancers, there is a paucity of data regarding strategy for their optimal treatment. Generally, outcomes of advanced and higher grade tumors remain unsatisfactory, despite the employment of sophisticated surgical approaches, technical advances in radiation techniques and the use of heavy ion particles. In this context, we critically evaluated the role of systemic therapy as part of a multidisciplinary approach to locally advanced disease. Results: Induction chemotherapy has shown encouraging activity and could have a role in the multimodal treatment of patients with advanced sinonasal tumors. For epithelial tumors, the most frequently employed chemotherapy is cisplatin, in combination with either 5-fluorouracil, taxane, ifosfamide, or vincristine. Only limited experiences with concurrent chemoradiation exist with sinonasal cancer. The role of systemic treatment for each histological type (intestinal-type adenocarcinoma, sinonasal undifferentiated carcinoma, sinonasal neuroendocrine carcinoma, olfactory neuroblastoma, sinonasal primary mucosal melanoma, sarcoma) is discussed. Conclusions: The treatment of SNC requires a multimodal approach. Employment of systemic therapy for locally advanced disease could result in better outcomes, and optimize the therapeutic armamentarium. Further studies are needed to precisely define the role of systemic therapy and identify the optimal sequencing for its administration in relation to local therapies.

Original languageEnglish (US)
Pages (from-to)836-843
Number of pages8
JournalCancer Treatment Reviews
Issue number10
StatePublished - 2015


  • Chemotherapy
  • Multimodality treatment
  • Sinonasal cancer
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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