Paranasal Sinus and Nasal Cavity Cancers: Systematic Review and Executive Summary of the American Radium Society Appropriate Use Criteria
Recommended Citation
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, and Margalit DN. Paranasal Sinus and Nasal Cavity Cancers: Systematic Review and Executive Summary of the American Radium Society Appropriate Use Criteria. Head Neck 2025;47(8):2073-2091.
Document Type
Article
Publication Date
8-1-2025
Publication Title
Head & neck
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.
Medical Subject Headings
Humans; Nose Neoplasms; Paranasal Sinus Neoplasms; Nasal Cavity; United States; Societies; Medical; Combined Modality Therapy; Neoplasm Staging
PubMed ID
40344605
ePublication
ePub ahead of print
Volume
47
Issue
8
First Page
2073
Last Page
2091
