Sinonasal Neuroendocrine Carcinoma: Is Induction Chemotherapy and Definitive Chemoradiation Associated with Worse Outcomes? A Case Series

Background: Sinonasal malignancies are a rare and heterogeneous group of neoplasms, the primary treatment of which has traditionally involved surgical resection. However, recent studies on sinonasal undifferentiated carcinoma have demonstrated survival benefit with the use of induction chemotherapy as a marker of biologic behavior and treatment decision-making. The use of such an approach has been explored with other sinonasal malignancies as a potential alternative to surgical resection, especially in patients with extensive disease. However, such a protocol may be less effective for certain etiologies, especially those of neuroendocrine origin. Literature on small cell lung cancer has shown that induction chemotherapy and definitive chemoradiation may be associated with rapid recurrence, and may be inferior to upfront surgical resection.

Methods: We present a literature review and a three patient case series with undifferentiated sinonasal neuroendocrine carcinoma that were all treated with induction chemotherapy and subsequent chemoradiation.

Result: All three patients experienced a significant reduction in their disease burden with induction chemotherapy, but unfortunately every patient has a subsequent extensive recurrence of their carcinoma, with two patients ultimately succumbing to the malignancy.

Conclusion: This review of the literature and case series serves to demonstrate while induction chemotherapy and definitive chemoradiation has changed the treatment paradigm with SNUC, primary surgical resection with adjuvant therapy should be consider for sinonasal neuroendocrine carcinoma when R0 resection is feasible.

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Artikel online veröffentlicht:
01. Februar 2023