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Recurrent Paranasal Sinus and Nasal Cavity Cancer

    Chemotherapy for recurrent head and neck squamous cell cancer has shown promise. Chemotherapy may be indicated where there is recurrence in either distant or local disease after primary surgery or radiation, and when there is residual disease after primary treatment.[1,2] Survival may be improved in those achieving a complete response to chemotherapy.[3] Combined modality therapy with platinum and radiation therapy has been used in trials such as UMCC-8810.[4]

    Standard treatment options:

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    Use of Levels of Evidence

    The PDQ editorial boards use a ranking system of levels of evidence to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. For any given therapy, results of prevention and treatment studies can be ranked on each of the following two scales: Strength of the study design. Strength of the endpoints. Together, the two rankings provide a measure of the overall level of evidence. Screening studies are ranked on strength of study design alone...

    Read the Use of Levels of Evidence article > >

    1. For maxillary sinus tumors:
      • After surgery, radiation therapy or craniofacial resection with postoperative radiation therapy.
      • After radiation therapy, craniofacial resection if indicated.
      • Chemotherapy should be considered after failure of the above.
    2. For ethmoid sinus tumors:[5,6,7]
      • After limited surgery, craniofacial resection or radiation therapy or both.
      • After radiation therapy, craniofacial resection.
      • Chemotherapy should be considered after failure of the above.
    3. For sphenoid sinus tumors:
      • Treatment is the same as for nasopharyngeal cancers, primarily radiation therapy.
      • Chemotherapy should be considered after failure of the above.
    4. For nasal cavity tumors (squamous cell carcinomas) salvage is possible in approximately 25% of patients:
      • For failure after radiation therapy, craniofacial resection.
      • For failure after surgery, radiation therapy.
      • Chemotherapy should be considered after failure of the above.
    5. For inverting papilloma:
      • Surgical excision.
      • Re-excision for surgery failures.
      • Radical surgery or radiation therapy may eventually be necessary.
    6. For melanomas and sarcomas:
      • Surgical excision if possible.
      • Appropriate chemotherapy geared specifically to cell type. (Refer to the Recurrent Nasopharyngeal Cancer section and the Recurrent Major Salivary Gland Cancer section of the PDQ summaries on Nasopharyngeal Cancer Treatment and Salivary Gland Cancer Treatment, respectively, for more information.)
    7. For midline granuloma:
      • Radiation therapy to nasal cavity and paranasal sinuses.
    8. For nasal vestibule tumors:
      • For radiation therapy failures, surgery.
      • For surgery failures, radiation therapy or a combination of surgery and radiation therapy.
      • Chemotherapy should be considered after failure of the above.

    Treatment options under clinical evaluation:

    • For maxillary sinus tumors, ethmoid sinus tumors, nasal cavity tumors, and nasal vestibule tumors, clinical trials using chemotherapy should be considered.[8,9]

    Current Clinical Trials

    Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent paranasal sinus and nasal cavity cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

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