F7.05 preoperative chemotherapy for ethmoid malignant tumours

Ethmoid malignant tumours are rare, often involve the anterior skull hase and require a multidisciplinary surgical approach. The cure rates reported by many authors, also in our experience with a craniofacial resection depend on tumour extension and histology of the tumour and are about 50%. In order to try to improve local and distant tumour control, we began to treat these patients with preoperative chemotherapy. The chemotherapy cycle includes CDDP. FU and Leucovorin. In 1996, 14 patients were entered into the study. All of them were males, median age 55 years (range 43-69). Histology was adenocarcinoma in 12 and squatnous carcinoma in 2. Three patients completed 5 cycles of chemotherapy. 3 received 4 cycles (2 cases are on treatment). 2 received 3 cycles, 4 received 2 cycles and 2 received 1 cycle. Chemotherapy toxicity was as follows: severe cardiotoxicity 3. Grade II-III nausea and vomiting in 10/14 patients. Grade II-III mucositis in 9/14. Grade IV leucopenia in 1/14. Grade I-II anaemia in 9/14. There were no treatment-related deaths. Response rate was 50% ; radiological complete remission rate was 21 %. In 28% (4 patients), a pathological complete remission was observed on the specimen after an anterior craniofacial resection. After a mean follow-up of 6 months, the 8 patients receiving surgery are alive and well.