Clinical efficacy and influencing factors of intensity-modulated radiation therapy in the treatment of sinonasal cancer.

OBJECTIVES: This study aimed to evaluate the clinical response of intensity-modulated radiation therapy (IMRT) in advanced sinonasal cancer (SNC), and to investigate the clinicopathological factors influencing treatment outcomes. METHODS: A retrospective analysis was conducted on data from 110 patients with advanced SNC admitted between 2016 and 2020. After balancing baseline characteristics through propensity score matching, 96 patients were included in the analysis and divided into an observation group (OG, n=48) and a control group (CG, n=48). OG received IMRT combined with docetaxel and cisplatin chemotherapy, while CG received IMRT alone. Clinical data, molecular biomarker expression levels, and remedy outcomes were compared. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify factors influencing patients' overall survival (OS). RESULTS: No significant differences existed in baseline characteristics between groups (all P>0.05). OG demonstrated significantly superior outcomes versus CG in terms of overall clinical response rate, 3-year OS, progression-free survival (PFS), and local recurrence-free survival (LRFS) (all P<0.05). Multivariate analysis identified the following independent risk factors: radiotherapy alone (affecting OS, PFS, LRFS); advanced age and poor differentiation (affecting OS); positive expression of epidermal growth factor receptor and vascular endothelial growth factor (affecting OS and PFS); cervical lymph node metastasis (affecting PFS and LRFS); and positive P53 expression (affecting OS and LRFS) (all P<0.05). CONCLUSION: IMRT combined with docetaxel and cisplatin chemotherapy significantly improves the prognosis of advanced SNC. Treatment modality, patient age, tumor differentiation, lymph node status, and molecular markers are all independent prognostic factors, indicating the potential for individualized treatment strategies under comprehensive assessment.