Sinonasal neuroendocrine tumors are a challenging group of diseases to manage, due to their rarity and heterogeneous natural histories. New multimodality strategies need to be explored to potentially enhance outcomes, especially in non-ONB histologies.
Priya Parikh, BA, Samir H. Patel, MD, Mauricio Gamez, MD, William Wong, MD, Michele Halyard, MD, Kelly Curtis, MD, Devyani Lal, MD; Department of Radiation Oncology, Department of Medical Oncology, Department of Otorhinolaryngology, Mayo Clinic Arizona
PURPOSE/OBJECTIVES: To report the treatment outcomes of patients with sinonasal neuroendocrine tumors who were treated with a combination of surgery, radiation therapy, and/or chemotherapy at the Mayo Clinic in Arizona.
MATERIALS AND METHODS: An institutional review board (IRB)-approved retrospective study of 27 patients treated at the Mayo Clinic from January 25, 1996 through November 6, 2013. Of these patients, 9 (33%) had olfactory neuroblastoma (ONB), 11 (41%) had sinonasal undifferentiated carcinoma (SNUC), 5 (19%) had small-cell carcinoma, and 2 (7%) had neuroendocrine carcinoma.
Of the 27 patients, 22 patients received a combination of surgery, radiation therapy, and/or chemotherapy: 9 (41%) underwent surgery plus adjuvant radiation, 8 (36%) underwent surgery plus adjuvant chemoradiation, 4 (18%) were treated with chemoradiation, and 1 (5%) had neoadjuvant chemotherapy followed by surgery and adjuvant radiation. Two patients were treated with surgery alone, one was treated with radiation therapy alone, and two were treated with chemotherapy alone. The median dose of radiation was 60 Gy (range: 42–66 Gy).
RESULTS: Median follow-up was 16.3 months (range: 3–315 mo). The 5-year actuarial overall survival (OS), distant metastasis–free survival (DMFS), and local control (LC) rates were 44%, 62%, and 51%, respectively. When comparing outcomes of ONB vs non-ONB histologies, 5-year OS was 56% vs 38% (P = .4), and 5-year LC was 67% vs 37%, respectively (P = .6). Specifically, SNUC patients had the worst 5-year OS of 25% and 5-year LC of 39%. Moreover, 50% of SNUC patients developed distant failure within 1 year. There were five regional recurrences in the neck-all in ONB patients. One of these five patients had a regional-only recurrence and did not receive elective radiation to the neck.
CONCLUSIONS: Sinonasal neuroendocrine tumors are a challenging group of diseases to manage, due to their rarity and heterogeneous natural histories. New multimodality strategies need to be explored to potentially enhance outcomes, especially in non-ONB histologies.
Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org