Table of Contents
Chemotherapy Research and Practice
Volume 2014 (2014), Article ID 487872, 6 pages
http://dx.doi.org/10.1155/2014/487872
Clinical Study

Induction Chemotherapy in Technically Unresectable Locally Advanced Carcinoma of Maxillary Sinus

1Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
2Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
3Department of Head & Neck Surgery, Tata Memorial Hospital, Mumbai, India

Received 25 November 2013; Revised 23 March 2014; Accepted 3 April 2014; Published 11 May 2014

Academic Editor: Enzo Bonmassar

Copyright © 2014 Vanita Noronha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Locally advanced carcinoma of maxillary sinus has been historically reported to have poor prognosis. We evaluated the role of NACT in improving the outcome in these patients. Methods. 41 patients with locally advanced technically unresectable (stage IVa) or unresectable maxillary carcinoma (stage IVb) were treated with induction chemotherapy between 2008 and 2011. The demographic profile, response and toxicity of chemotherapy, definitive treatment received, progression free survival (PFS), and overall survival (OS) were analyzed. Univariate and multivariate analysis were performed to determine factors associated with PFS and OS. Results. The chemotherapy included two drugs (platinum and taxane) in 34 patients (82.9%) and three drugs (platinum, taxane, and 5 FU) in 7 (17.1%). There was no complete response seen in any of the patients, stable disease in 18 (43.9%), partial response in 16 (39%), and progression in 7 (17.1%) patients. After induction, the treatment planned included surgery in 12 (29.3%), CT-RT in 24 (58.5%), radical RT in 1 (2.4%), palliative RT in 1 (2.4%), and palliative chemotherapy in 3 (7.3%) patients. Overall, the median PFS was 10.0 months. The OS at 24 months and 36 months was 41% and 35%, respectively. Conclusion. In unresectable maxillary carcinoma, induction chemotherapy has clinically significant benefit with acceptable toxicity.