Stage II Paranasal Sinus and Nasal Cavity Cancer
Stage II disease includes small and moderately advanced lesions.
Standard treatment options:
- For maxillary sinus tumors:
- Surgical resection with high-dose preoperative or postoperative radiation therapy.
- For ethmoid sinus tumors (lesions are usually extensive when diagnosed):[1-3]
- Generally, external-beam radiation therapy alone is used and produces better overall results than surgery.
- Well-localized lesions can be resected, but resection of the ethmoids, maxilla, and orbit, often with a combined neurosurgical sinus craniofacial approach, is generally required.
- If surgery can be done with good functional and cosmetic results, postoperative radiation therapy should be given even with clear surgical margins.
- For sphenoid sinus tumors:
- Treatment is the same as for nasopharyngeal cancers, primarily radiation therapy. (Refer to the Stage II Nasopharyngeal Cancer section in the PDQ summary on Nasopharyngeal Cancer Treatment for more information.) Concomitant chemotherapy and radiation therapy may be considered.
- For nasal cavity tumors (squamous cell carcinomas), treatment preferences are either surgery or radiation therapy, which have equal cure rates:
- Surgery or radiation therapy for tumors of the septum.
- Radiation therapy for tumors of the lateral and superior walls. Concomitant chemotherapy and radiation therapy may be considered.
- Surgery plus radiation therapy for tumors of the septal and lateral walls.
- For inverting papilloma:
- Surgical excision.
- Re-excision for surgery failures.
- Radiation therapy for radical surgery failures may eventually be necessary.
- For melanomas and sarcomas:
- Surgical excision if possible.
- Combined surgery, radiation, and chemotherapy are recommended for rhabdomyosarcoma.
- For midline granuloma:
- Radiation therapy to nasal cavity and paranasal sinuses.
- For nasal vestibule tumors:
- Surgery or radiation therapy may be performed. If tumors are extremely small, surgery is preferred provided that no deformity is expected and a need for reconstruction is not anticipated. Radiation therapy is preferred for other small lesions.[6,7] Treatment of the neck should be considered.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II paranasal sinus and nasal cavity cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.References
- Kraus DH, Sterman BM, Levine HL, et al.: Factors influencing survival in ethmoid sinus cancer. Arch Otolaryngol Head Neck Surg 118 (4): 367-72, 1992. [PUBMED Abstract]
- Cantù G, Solero CL, Mariani L, et al.: Anterior craniofacial resection for malignant ethmoid tumors--a series of 91 patients. Head Neck 21 (3): 185-91, 1999. [PUBMED Abstract]
- Shah JP: Surgery of the anterior skull base for malignant tumors. Acta Otorhinolaryngol Belg 53 (3): 191-4, 1999. [PUBMED Abstract]
- Hawkins RB, Wynstra JH, Pilepich MV, et al.: Carcinoma of the nasal cavity--results of primary and adjuvant radiotherapy. Int J Radiat Oncol Biol Phys 15 (5): 1129-33, 1988. [PUBMED Abstract]
- Ang KK, Jiang GL, Frankenthaler RA, et al.: Carcinomas of the nasal cavity. Radiother Oncol 24 (3): 163-8, 1992. [PUBMED Abstract]
- Levendag PC, Pomp J: Radiation therapy of squamous cell carcinoma of the nasal vestibule. Int J Radiat Oncol Biol Phys 19 (6): 1363-7, 1990. [PUBMED Abstract]
- Wong CS, Cummings BJ: The place of radiation therapy in the treatment of squamous cell carcinoma of the nasal vestibule. A review. Acta Oncol 27 (3): 203-8, 1988. [PUBMED Abstract]