When do you consider upfront surgery for locally advanced (T4) sinonasal CA?
Would you proceed with induction chemotherapy (eg TPF or cis/gem) to downstage or neoadjuvant chemoRT? Would your approach be different if there is orbital apex or focal dural invasion?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · UCSD Radiation Oncology
Answered on
I usually favor upfront induction chemotherapy for the unresectable cases or if upfront surgery has the risk of unacceptable morbidity. We then evaluate the role of surgery based on histology. For most histologic sub-types of sino-nasal malignancy, we favor primary surgical resection (salivary gland...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Medical Oncology · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Answered on
I guess this is SNUC in which case, surgical R0 resection results in best outcomes. If there is intracranial extension or surgery would involve morbid procedures such as orbital exenteration, I would favor neoadjuvant chemo. There is some data for TPF followed by chemoradiation. If there is a trial ...
Join for free or sign in to see the full answer