Randomized study of neoadjuvant chemotherapy for organ preservation in T3 and T4a nasal and paranasal sinus squamous cell carcinoma

The multicenter ECOG-ACRIN EA3163 trial compared surgery alone (arm A) versus three neoadjuvant cycles of docetaxel-cisplatin (arm B) for T3/T4a and select T4b nasal and paranasal sinus squamous cell carcinoma (NPNSCC) requiring orbital or base of skull resection. Primary endpoint was structure preservation (SP). Among T3/T4a patients, SP rate was 18% in arm A and 71% in arm B (p=0.049). The most common grade ≥ 3 toxicities included mucositis, anemia, nausea, and lymphopenia; no grade 5 events were reported. The authors conclude that these results support neoadjuvant chemotherapy as an effective intervention for SP in T3/T4a NPNSCC.