Chemotherapy for Nasal Cavity and Paranasal Sinus Cancers

Chemotherapy (chemo) uses anti-cancer drugs that are put into a vein or taken by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancer that has metastasized (spread) to organs beyond the nasal cavity and paranasal sinuses.

The best way to use chemo to treat nasal cavity and paranasal sinus cancers is not clear. But it may be used in these ways:

  • Before surgery (often along with radiation therapy) to try to shrink the tumor and make easier to take it all out ( with negative margins). This is called neoadjuvant chemotherapy. It may also be called induction chemotherapy.
    • Neoadjuvant chemo may be used to try to save the eyeball if the cancer has spread there.
    • It may also be used before surgery to quickly ease symptoms the tumor is causing.
  • After surgery (often along with radiation therapy) to help lower the chance the cancer will come back. This is called adjuvant chemotherapy.
  • As the main treatment (often along with radiation therapy) for cancers that are too big or have spread too far into nearby tissues to be completely removed with surgery.
  • It may be used to control cancer growth and spread when it has metastized (spread) to other parts of the body and cannot be treated with surgery or radiation. (Because these cancers rarely metastasize, this use is based on results that have been seen with other kinds of head and neck cancers.) This is called palliative care.

Chemoradiation

Chemoradiation (also called chemoradiotherapy) is chemotherapy given at the same time as radiation. This has been shown to shrink some of these tumors more than either treatment alone. It's also may help delay cancer recurrence (coming back after treatment) in some types of cancer (carcinomas; see below).

Chemo drugs commonly used

Chemo for nasal cavity and paranasal sinus cancers may include a combination of several drugs. These cancers are rare, so there aren’t many studies to help doctors decide the best way to treat them. Often, doctors treat them with the same drugs that are used for other, more common, cancers of the head and neck.

The most common types of nasal cavity and paranasal sinus cancers, squamous cell carcinoma, adenocarcinoma, and adenoid cystic carcinoma, can be grouped together as carcinomas. Some of the chemo drugs used to treat carcinomas include:

  • Cisplatin
  • Carboplatin
  • 5-fluorouracil (5-FU)
  • Docetaxel (Taxotere®)
  • Paclitaxel (Taxol®)
  • Methotrexate

The drugs used depend on many things, including the type of cancer, the extent of the cancer, the person’s overall health, and whether chemo is combined with radiation therapy. Cisplatin is the drug most often given with radiation. It's often combined with 5-FU and/or docetaxel. New chemo drugs and combination treatments are also being studied and used.

The targeted therapy drug, cetuximab, may also be given with chemo in certain cases.

Different chemo drugs are used for sarcomas and melanomas. Information about chemotherapy for sarcomas may be found in Sarcoma: Adult Soft Tissue Cancer. Chemo for melanoma is covered in Melanoma Skin Cancer.

Side effects of chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be damaged by chemo, which can lead to side effects. Side effects depend on the specific drugs used, the doses, and the length of treatment. Common short-term side effects of chemo include:

Chemo often affects the blood-forming cells of the bone marrow, this can lead to:

  • Increased chance of infection (from a shortage of white blood cells)
  • Bleeding or bruising after minor cuts or injuries (from a shortage of blood platelets)
  • Fatigue (from low red blood cell counts)

There are often ways to lessen these side effects, and they usually go away over time after treatment ends. Be sure to ask your doctor or nurse what can be done to help reduce side effects, and let them know when you do have side effects so they can be managed. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Some side effects continue long after treatment is stopped. For example, cisplatin can cause nerve damage (neuropathy). This can sometimes lead to hearing loss or problems in the hands and feet such as pain, burning or tingling sensations, sensitivity to cold or heat, or weakness. In most cases this gets better or goes away once treatment stops, but for some people, it can last a long time.

If your doctor plans treatment with chemo you should be sure to discuss which drugs will be used and the possible side effects. Once chemo is started, let your health care team know if you have side effects, so they can be treated.

To learn more, see the Chemotherapy section on our website.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared 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 Medical Review: April 22, 2014 Last Revised: August 8, 2016

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