Treatment of Nasal Cavity Cancer in High-Grade or Poorly Differentiated Sinonasal Carcinoma
High-grade and poorly differentiated sinonasal tumours are an aggressive subset of nasal cavity cancer for which a structured, histotype-informed treatment approach is indicated. This protocol addresses that specific population.
Clinical scenario
This protocol applies to patients with high-grade or poorly differentiated sinonasal carcinoma. Covered histological subtypes include:
Squamous-cell carcinoma (SCC)
Hyams grade III–IV olfactory neuroblastoma
Sinonasal undifferentiated carcinoma (SNUC)
Sinonasal neuroendocrine carcinoma (SNEC)
Small-cell neuroendocrine carcinoma (SCNEC)
Poorly/non-differentiated sinonasal carcinoma NOS
NUT carcinoma
SWI/SNF complex-deficient sinonasal carcinoma
Treatment approach (overview)
Neoadjuvant chemotherapy (NACT) with a histotype-driven, platinum-based regimen is the indicated approach. The specific regimen is selected according to the tumour’s histological subtype. The complete regimen, dosing schedule, and sequencing algorithm are available in the full protocol.
Treatment goal
- Achieve partial or complete tumour response, assessed by contrast-enhanced locoregional imaging (CT or MRI) after a defined number of treatment cycles
References
DOI: 10.1016/j.esmoop.2024.104121
- Neoadjuvant chemotherapy (NACT) may be indicated in high-grade and poorly differentiated tumours.
- NACT should be considered in high-grade and poorly differentiated tumours [III, A].
- The most frequently used NACT agents are platinum-based compounds, usually in combination with 5-FU, taxane, ifosfamide, doxorubicin or etoposide.
- When considered for SCC, SNUC, SNEC, SCNEC and Hyams grade III–IV ONB (i.e. rapidly evolving tumours), evaluation of NACT response and restaging through contrast-enhanced locoregional imaging (i.e. CT or MRI) should be carried out at the latest after two cycles [IV, A].
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