What’s New in Nasal Cavity and Paranasal Sinus Cancer Research and Treatment?

Research on prevention of and better treatment for nasal cavity and paranasal sinus cancers is now being done at many medical centers, university hospitals, and other institutions across the nation. Doctors and patients are urged to contact the nearest cancer center to find out what clinical trials are going on in their community.


Little is known about the gene changes in nasal cavity and paranasal sinus cancer because this cancer is so rare. Still, scientists have found some changes in the genes of some head and neck cancer cells that may be what change normal cells into cancer cells. But more research is needed to clearly identify these changes and link them to nasal cavity and nasopharyngeal cancers.

Understanding these gene changes may help doctors find better ways to diagnose these cancers. It may also lead to treatments that work better and have fewer side effects than those used today.



Surgeons are looking at new ways to remove these cancers while doing as little damage as possible to nearby normal tissues. Researchers are also looking for better ways to combine surgery with other cancer treatments to get better outcomes.

Selective lymph node dissection is another research interest. Studies have suggested that even patients who do not appear to have cancer in their lymph nodes have better outcomes when surgery is done to check the nodes close to the cancer compared to patients who have no lymph node treatment or elective neck radiation. More research is needed to know which patients should be offered these options.

Studies are looking at the possibility of reconstruction, or rebuilding the effected bony parts of the face, and how to best do it. Bone and tissue grafts, as well as man-made materials are being studied.

Radiation therapy

Doctors are always looking better ways to focus radiation on tumors more precisely to get more radiation to the tumor while limiting damage to nearby areas. This is especially important for head and neck tumors like nasal cavity and paranasal sinus cancers, where there are many important structures (like the eyes and brain), blood vessels, and nerves close to the tumor.

Research looking at whether proton therapy (which uses proton beams instead of x-rays) could work better than IMRT. (IMRT is the type of radiation most often used today.) Proton therapy could allow doctors to give higher doses of radiation to the cancer with less damage to the tissues the rays pass through. This might also cause fewer side effects, like mouth pain, eating problems, and weight loss.

Different radiation schedules are also being studied. For instance, instead of giving one large dose of radiation each day, there may be less damage to the eyeball and optic nerve if radiation is split into 2 smaller doses each day. This is called hyperfractionation and needs to be studied more.

Improvements in radiation have also led doctors to test repeating radiation treatments for cancers that come back after the initial course of treatment.


Doctors are looking at how chemotherapy can be used with other treatments to improve outcomes, especially for bigger cancers that may have already spread. Induction chemotherapy -- chemo given before surgery and/or radiation -- is of special interest because studies suggest that it may help preserve the eyeball in people with advanced disease. It's also been linked to longer survival.

Intra-arterial chemo (putting drugs right into the blood vessels feeding the tumor) for advanced cancers is another area of interest. Research has suggested that this might help reduce damage to the nearby tissues -- especially the eyeball. Still, there are a lot of side effects seen with this treatment, and more research is needed to know if it helps.

More research is needed to know when to use chemotherapy and which chemo drug combinations are best for these cancers.

Targeted therapies

Clinical trials are studying several targeted therapies that block the action of the substances (such as growth factors and growth factor receptors) that cause head and neck cancers to grow and spread. Cetuximab is already used in some cases, and pembrolizumab and bevacizumab are also being studied. Many studies are testing combinations of targeted therapies plus chemo or radiation. As has been the case with many other kinds of cancer, targeted therapies may prove to be a great advancement in the treatment of nasal cavity and paranasal sinus cancers.


Photodynamic therapy or PDT uses drugs and light to treat small cancers that can be reached with lasers. Researchers are looking at how this treatment might be used to treat recurrent esthesioneuroblastoma and other paranasal sinus tumors that come back after treatment.

Because nasal cavity and paranasal sinus cancers are rare, nearly all clinical trials include patients with other types of head and neck cancer as well. Although these studies are not specific to nasal cavity and paranasal sinus cancers, doctors will be able to apply the results when choosing treatment for patients with nasal cavity and paranasal sinus cancers.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Last Revised: December 1, 2017

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