The impact of antitumor effect severity on the long-term results of treatment of patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses

Introduction. Squamous cell carcinoma of the nasal cavity and paranasal sinuses is one of the rare malignancies. In about 80 % of cases, this pathology is diagnosed at stage III–Iv, which causes an unfavorable prognosis of the disease.

Aim. To evaluate effectiveness of an integrated approach to treatment of stage III–Iv squamous cell carcinoma of the nasal cavity and paranasal sinuses.

Materials and methods. The study included 126 patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses who were treated and observed during 2000–2020 at the N. N. Blokhin National medical Research Center for Oncology. Depending on the choice of treatment tactics at the 1^st stage, patients were divided into 3 groups. group 1 (n = 55) included patients who underwent conservative treatment (radiation or chemoradiation) therapy in an independent version, group 2 (n = 31) – patients who underwent surgery with adjuvant radiation therapy, group 3 (n = 40) – patients who underwent induction radiation or chemoradiation therapy with subsequent surgery. Results. Overall 5-year survival rates did not differ between the 3 groups (p >0.05). At the same time, 5-year progression-free survival in group 2 (surgery + adjuvant radiation or chemoradiation therapy) was significantly higher (50.5 %) as compared with groups 1 (conservative treatment) (17 %; p = 0.021) and 3 (induction radiation or chemoradiation therapy + surgery) (25.5 %; p = 0.031). The five-year progression-free survival of patients with T3 tumor in group 2 was 59.4 %, which was significantly higher than in groups 1 (17.9 %; p = 0.021) and 3 (27.1 %; p = 0.031). However, there were no between-group differences in progression-free survival in patients with T4 tumor.

Conclusion. Local recurrence is the most common cause of disease progression. Surgery with adjuvant radiation therapy, especially in patients with T3 tumor, improves the prognosis of the disease. At the same time, it is advisable to conduct conservative treatment to patients with T4 tumor.

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