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Otolaryngol Head Neck Surg. 2019 Apr;160(4):658-663. doi: 10.1177/0194599818804777. Epub 2018 Oct 9.

Survival Outcomes for Induction vs Adjuvant Chemotherapy in Squamous Cell Carcinoma of the Maxillary Sinus.

Author information

1
1 Department of Surgery, Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA.
2
2 Center for Head & Neck Oncology, New York Head & Neck Institute, North Shore-LIJ Cancer Institute, New York, New York, USA.
3
3 Center for Thyroid & Parathyroid Surgery, New York Head & Neck Institute, New York, New York, USA.
4
4 Yale Cancer Center, New Haven, Connecticut, USA.

Abstract

OBJECTIVE:

In advanced maxillary sinus cancers treated with surgery and radiotherapy, poor local control rates and the potential for organ preservation have prompted interest in the use of systemic therapy. Our objective was to present outcomes for induction compared to adjuvant chemotherapy in the maxillary sinus.

STUDY DESIGN:

Secondary database analysis.

SETTING:

National Cancer Database (NCDB).

SUBJECTS AND METHODS:

In total, 218 cases of squamous cell maxillary sinus cancer treated with surgery, radiation, and chemotherapy between 2004 and 2012 were identified from the NCDB and stratified into induction chemotherapy and adjuvant chemotherapy cohorts. Univariate Kaplan-Meier analyses were compared by log-rank test, and multivariate Cox regression was performed to evaluate overall survival when adjusting for other prognostic factors. Propensity score matching was also used for further comparison.

RESULTS:

Twenty-three patients received induction chemotherapy (10.6%) and 195 adjuvant chemotherapy (89.4%). The log-rank test comparing induction to adjuvant chemotherapy was not significant ( P = .076). In multivariate Cox regression when adjusting for age, sex, race, comorbidity, grade, insurance, and T/N stage, there was a significant mortality hazard ratio of 2.305 for adjuvant relative to induction chemotherapy (confidence interval, 1.076-4.937; P = .032).

CONCLUSION:

Induction chemotherapy was associated with improved overall survival in comparison to adjuvant chemotherapy in a relatively small cohort of patients (in whom treatment choice cannot be characterized), suggesting that this question warrants further investigation in a controlled clinical trial before any recommendations are made.

KEYWORDS:

chemotherapy; maxillary sinus cancer; survival outcomes

PMID:
30296902
DOI:
10.1177/0194599818804777

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