Skip to content
My WebMD Sign In, Sign Up

Cancer Health Center

Font Size

Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage IV Paranasal Sinus and Nasal Cavity Cancer

Stage IV disease includes advanced lesions.

Standard treatment options:

Recommended Related to Cancer

Sweats and Hot Flashes

Overview Sweats and hot flashes are common in cancer survivors, from those in the adjuvant setting to those living with advanced disease. Pathophysiologic mechanisms are complex. Treatment options are broad-based, including hormonal agents, nonhormonal pharmacotherapies, and diverse integrative medicine modalities.[1] Physiologically, sweating mediates core body temperature by producing transdermal evaporative heat loss.[2,3] Sweating occurs in disease states such as fever and in nondisease...

Read the Sweats and Hot Flashes article > >

  1. For maxillary sinus tumors:
    • High-dose radiation therapy is used because extension to base of skull and nasopharynx is a potential, but not absolute, contraindication to surgery. If radiation therapy is to be used alone, localized drainage of the sinus(es) must be established before initiating radiation therapy treatments.
  2. For ethmoid sinus tumors:[1,2,3]
    • Generally a craniofacial resection in combination with preoperative or postoperative radiation therapy.
    • Concomitant chemotherapy and radiation therapy may be considered for patients with inoperable tumors.
  3. For sphenoid sinus tumors:
    • Treatment is the same as for nasopharyngeal cancers, primarily radiation therapy. (Refer to the Stage IV Nasopharyngeal Cancer section in the PDQ summary on Nasopharyngeal Cancer Treatment for more information.)
    • Concomitant chemotherapy and radiation therapy may be considered.
  4. For nasal cavity tumors (squamous cell carcinomas):
    • Surgery alone.
    • Radiation alone.[4] Concomitant chemotherapy and radiation therapy may be considered.
    • Combined surgery and radiation therapy (postoperative radiation therapy is preferred).[4]
  5. For inverting papilloma:
    • Surgical excision.
    • Re-excision for surgery failures.
    • Radiation therapy or radical surgery may eventually be necessary.
  6. For melanomas and sarcomas:
    • Surgical excision if possible.
    • Appropriate radiation and various chemotherapy agents should be considered.
  7. For midline granuloma:
    • Radiation therapy to nasal cavity and paranasal sinuses.
  8. For nasal vestibule tumors:
    • Generally, radiation is preferred to minimize deformity. External-beam (i.e., photons or electrons) and/or interstitial implantation can be used. Surgery is reserved for salvage. Treatment of the neck should be considered.

Treatment options under clinical evaluation:

  1. For maxillary sinus tumors:
    • Superfractionated radiation therapy.[5]
  2. For maxillary sinus tumors, ethmoid sinus tumors, nasal cavity tumors, and nasal vestibule tumors:
    • Clinical trials for advanced tumors should be considered to evaluate chemotherapy preoperatively or before radiation therapy, as is adjuvant therapy after surgery or after combined modality therapy.
    • Concomitant chemotherapy and radiation therapy may be considered.

Neoadjuvant chemotherapy as employed in clinical trials has been used to shrink tumors and to render them more definitively treatable with either surgery or radiation. This chemotherapy is given prior to the other modalities; therefore, the designation of neoadjuvant is used to distinguish it from standard adjuvant therapy, which is given after or during definitive therapy with radiation or after surgery. Many drug combinations have been used in neoadjuvant chemotherapy.[6,7,8]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV 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:

  1. 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.
  2. 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.
  3. Shah JP: Surgery of the anterior skull base for malignant tumors. Acta Otorhinolaryngol Belg 53 (3): 191-4, 1999.
  4. 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.
  5. Johnson CR, Schmidt-Ullrich RK, Wazer DE: Concomitant boost technique using accelerated superfractionated radiation therapy for advanced squamous cell carcinoma of the head and neck. Cancer 69 (11): 2749-54, 1992.
  6. Stupp R, Weichselbaum RR, Vokes EE: Combined modality therapy of head and neck cancer. Semin Oncol 21 (3): 349-58, 1994.
  7. Al-Sarraf M: Head and neck cancer: chemotherapy concepts. Semin Oncol 15 (1): 70-85, 1988.
  8. Dimery IW, Hong WK: Overview of combined modality therapies for head and neck cancer. J Natl Cancer Inst 85 (2): 95-111, 1993.
1

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

Building a Support System
Blog
cancer fighting foods
SLIDESHOW
 
precancerous lesions slideshow
SLIDESHOW
quit smoking tips
SLIDESHOW
 
Jennifer Goodman Linn self-portrait
Blog
what is your cancer risk
HEALTH CHECK
 
colorectal cancer treatment advances
Video
breast cancer overview slideshow
SLIDESHOW
 
prostate cancer overview
SLIDESHOW
lung cancer overview slideshow
SLIDESHOW
 
ovarian cancer overview slideshow
SLIDESHOW
Actor Michael Douglas
Article