In this study, the treatment results of patients with paranasal sinus tumors referred to our group and treated with multimodality treatment options were analysed. Between January 1992 and December 2003, 39 patients with paranasal sinus tumors were admitted to our group and 34 patients were evaluated in this study. Median age was 54 (17–78). Twenty one (62%) patients were male, and 13 (38%) patients were female. Twenty-eight (82%) patients had stage III-IV disease. Histopathological examination revealed malignant epithelial tumor in 26 (76%), malignant mesenchymal tumor in 6 (18%) and 2 (6%) malignant melanoma patients. Twenty-five (73%) patients were treated with surgery and adjuvant radiotherapy, 9 (17%) patients were treated with radiotherapy alone and 12 (35%) patients received platin based systemic chemotherapy (6 concomitant, 6 adjuvant). The median radiotherapy dose was 70 Gy (36–70 Gy) in definitive radiotherapy group and 60 Gy (50–66 Gy) in adjuvant radiotherapy group. In definitive radiotherapy group, the response rates were evaluated 3–6 months after the end of the radiotherapy and 4 patients had complete and 4 patients had partial response. There was no response in 1 patient. Overall survival and progression free survival rates for 2 and 5 years were 75%, 57% and 60%, 52% respectively. The overall survival rate at 5 years were 61% in surgery and adjuvant radiotherapy group, and 44% in radiotherapy alone group. Acute side effects were acceptable except one patient with grade IV skin reaction. Grade 3 and 4 late side effects were revealed in 7 (21%) patients. In conclusion, surgery and adjuvant radiotherapy improve the treatment results in locally advanced malignant paranasal sinus tumors. In patients which surgery cannot be performed, sufficient local control and survival rates can be obtained with radiotherapy alone or with chemoradiotherapy.

Bu çalısmada grubumuza refere edilen ve multidisipliner yaklasımla tedavi edilen paranazal sinüs tümörlü hastaların tedavi sonuçları değerlendirilmistir. Ocak 1992-Aralık 2003 tarihleri arasında grubumuza basvuran 39 paranazal sinüs tümörlü hastadan 34’ü önerilen tedaviyi almıslardır. Hastalara öncelikle cerrahi ve adjuvan radyoterapi planlanmakta, cerrahi uygulanmayan hastalara sadece radyoterapi veya kemoradyoterapi verilmektedir. Hastaların medyan yası 54 (17–78), 13 (%38)’ü kadın, 21 (%62)’i erkektir ve 28 (%82)’i evre III-IV’ dür. Histopatolojik dağılımda 26 (%76)’sı malign epitelyal tümör, 6 (%18)’sı malign mezenkimal tümörlerden ve 2 (%6)’sı malign melanomdan olusmaktadır. Hastalardan 25 (%73)’ine cerrahi ve adjuvan radyoterapi, 9 (%17)’una radikal radyoterapi ve 12 (%35)’sine (6’sına es zamanlı, 6’sına adjuvan) kemoterapi uygulanmıstır. Toplam radyoterapi dozu radikal radyoterapi grubunda medyan 70 Gy (36–70 Gy), adjuvan radyoterapi grubunda ise medyan 60 Gy’dir (50–66 Gy). Radikal radyoterapi sonrası 3–6 ayda yapılan klinik ve radyolojik değerlendirmede; 4/9 tam yanıt, 4/9 kısmi yanıt ve 1/9 yanıtsız hasta olduğu saptanmıstır. Tüm hastaların 2 ve 5 yıllık genel ve progresyonsuz sağkalım oranları sırasıyla; %75, %57 ve, %60, % 52’dir. Cerrahi ve radyoterapi uygulanan grupta sağkalım oranları sırasıyla; %79 ve %61 iken sadece radyoterapi alan grupta oranlar % 66 ve % 44 seklindedir. Erken dönemde 1 hastada 4. Derece cilt yan etkisi saptanmıstır. Geç dönemdeki değerlendirmede radikal radyoterapi grubunda 4 ve adjuvan radyoterapi grubunda 3 olmak üzere toplam 7 (%21) hastada ciddi yan etki saptanmıstır. Sonuçta yerel ileri evre paranazal sinüs tümörlerinde cerrahi ve radyoterapi ile daha iyi kontrol sağlanmakla birlikte, cerrahiye uygun olmayan hastalarda sadece radyoterapi veya kemoradyoterapi ile az sayıda hastayla elde edilen sonuçlar umut vericidir ve cerrahiye uygun olmayan hastalarda önerilmelidir.