Abstract：
BACKGROUND: Sinonasal malignancies (SNMs) frequently present with orbital invasion. Orbital exenteration (OE) can lead to significant morbidity. Induction chemotherapy (IC) is a promising treatment alternative that may allow for orbit preserving (OP) treatments without compromising patient survival. This systematic review was conducted to synthesize the published data on SNM patients with orbital invasion who underwent IC, including tumor response, orbital outcomes, and survival.
METHODS: The study protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases Embase, Cochrane, Medline, and Scopus, from inception to July 17, 2023, were searched.
RESULTS: Nineteen studies were included, encompassing 305 SNM patients with orbital invasion treated with IC. Fourteen studies reported an overall IC response rate (positive response defined as complete or partial tumor volume reduction) of 77.2%. Among included studies, OE rates after IC ranged from 0 to 40%. Three studies reported a high rate of posttreatment functional orbital preservation (89.8-96.0%). Five studies specifically reported that 62.5% (60 out of 96) of patients were downgraded from planned OE to OP treatment following IC. Three studies reported a significant overall survival (OS) improvement in IC responders versus IC nonresponders. Following IC, 5-year OS ranged from 44.2 to 55.5%. Patients with olfactory neuroblastoma demonstrated the highest IC response rate and lowest OE rate (100 and 0%, respectively) versus those with sinonasal undifferentiated carcinomas (68.4 and 0%) or squamous cell carcinomas (76.7 and 16%).
CONCLUSIONS: For select patients, IC may allow for OP in locally advanced SNMs with orbital involvement.
METHODS: The study protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases Embase, Cochrane, Medline, and Scopus, from inception to July 17, 2023, were searched.
RESULTS: Nineteen studies were included, encompassing 305 SNM patients with orbital invasion treated with IC. Fourteen studies reported an overall IC response rate (positive response defined as complete or partial tumor volume reduction) of 77.2%. Among included studies, OE rates after IC ranged from 0 to 40%. Three studies reported a high rate of posttreatment functional orbital preservation (89.8-96.0%). Five studies specifically reported that 62.5% (60 out of 96) of patients were downgraded from planned OE to OP treatment following IC. Three studies reported a significant overall survival (OS) improvement in IC responders versus IC nonresponders. Following IC, 5-year OS ranged from 44.2 to 55.5%. Patients with olfactory neuroblastoma demonstrated the highest IC response rate and lowest OE rate (100 and 0%, respectively) versus those with sinonasal undifferentiated carcinomas (68.4 and 0%) or squamous cell carcinomas (76.7 and 16%).
CONCLUSIONS: For select patients, IC may allow for OP in locally advanced SNMs with orbital involvement.
摘要：
背景：鼻窦恶性肿瘤（SNM）常伴有眼眶侵犯。眼眶放血(OE)可导致显著的发病率。诱导化疗（IC）是一种有前途的治疗方法，可以在不损害患者生存率的情况下进行眼眶保留（OP）治疗。这项系统评价是为了综合已发表的SNM患者眼眶侵犯患者接受IC的数据，包括肿瘤反应，轨道结果，和生存。
方法：根据系统评价和Meta分析指南的首选报告项目设计研究方案。数据库Embase,科克伦,Medline,还有Scopus,从成立到2023年7月17日，进行了搜索。
结果：纳入19项研究，包括305名接受IC治疗的眼眶侵犯的SNM患者。14项研究报告了77.2%的总体IC反应率(阳性反应定义为完全或部分肿瘤体积减小)。在纳入的研究中，IC后的OE率范围为0至40%。三项研究报告了治疗后功能性眼眶保留率很高（89.8-96.0％）。五项研究特别报道了62.5%(96人中有60人)的患者在IC后从计划的OE降级为OP治疗。三项研究报告IC反应者与IC无反应者相比，总生存期（OS）显着改善。在IC之后,5年OS范围为44.2％至55.5％。嗅觉神经母细胞瘤患者表现出最高的IC反应率和最低的OE率（100％和0％，分别）与鼻窦未分化癌（68.4和0％）或鳞状细胞癌（76.7和16％）的比较。
结论：对于选定的患者，IC可以允许在有轨道参与的本地先进的SNM中进行OP。
方法：根据系统评价和Meta分析指南的首选报告项目设计研究方案。数据库Embase,科克伦,Medline,还有Scopus,从成立到2023年7月17日，进行了搜索。
结果：纳入19项研究，包括305名接受IC治疗的眼眶侵犯的SNM患者。14项研究报告了77.2%的总体IC反应率(阳性反应定义为完全或部分肿瘤体积减小)。在纳入的研究中，IC后的OE率范围为0至40%。三项研究报告了治疗后功能性眼眶保留率很高（89.8-96.0％）。五项研究特别报道了62.5%(96人中有60人)的患者在IC后从计划的OE降级为OP治疗。三项研究报告IC反应者与IC无反应者相比，总生存期（OS）显着改善。在IC之后,5年OS范围为44.2％至55.5％。嗅觉神经母细胞瘤患者表现出最高的IC反应率和最低的OE率（100％和0％，分别）与鼻窦未分化癌（68.4和0％）或鳞状细胞癌（76.7和16％）的比较。
结论：对于选定的患者，IC可以允许在有轨道参与的本地先进的SNM中进行OP。
