Faculty Collaboration Database

Paranasal Sinus and Nasal Cavity Cancers: Systematic Review and Executive Summary of the American Radium Society Appropriate Use Criteria. Head Neck 2025 Aug;47(8):2073-2091

Date

05/09/2025

Pubmed ID

40344605

DOI

10.1002/hed.28177

Scopus ID

2-s2.0-105004698506 (requires institutional sign-in at Scopus site)

Abstract

Tumors of the paranasal sinus and nasal cavity (PNS/NC) are rare and exhibit diverse histology, anatomic subsite, and malignant potential. Early-stage disease is typically managed with surgery, and locally advanced disease is treated with a combination of surgery, radiotherapy, and chemotherapy. Clinical decision-making is commonly guided by limited retrospective evidence. To address this limitation, we performed a systematic review to inform evidence-based consensus for the management of common clinical scenarios, including the potential roles of radiation and systemic therapy to promote structural preservation, elective neck management, and radiation technique considerations. A librarian-mediated literature search identified 39 studies of adult patients with PNS/NC tumors treated with curative intent that met the study inclusion criteria. Search results were reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology. A modified-Delphi process was used to guide consensus for the appropriate use of various management strategies. Strong consensus existed for the appropriateness of primary surgery for early-stage disease, approaches to locally advanced disease with minimal periorbital fat invasion, and the use of induction chemotherapy with response-directed local therapy. Consensus regarding nodal treatment and the use of proton therapy in the adjuvant setting was less robust. The rarity and diversity of PNS/NC tumors limit randomized phase III trials to guide management. As such, this systematic review and appropriate-use consensus statements provide clinical guidance for the management of this challenging disease spectrum.

Author List

Witek ME, Ward MC, Bakst R, Chandra RA, Chang SS, Choi KY, Galloway T, Hanna GJ, Hu KS, Robbins J, Shukla ME, Siddiqui F, Takiar V, Walker GV, Fu Y, Margalit DN

Author

Monica E. Shukla MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Combined Modality Therapy
Humans
Nasal Cavity
Neoplasm Staging
Nose Neoplasms
Paranasal Sinus Neoplasms
Societies, Medical
United States