Emerging strategies and advances in the management of sinonasal carcinoma

Sinonasal tumors are rare and heterogeneous malignancies comprising 3-5% of head and neck cancers, often diagnosed at advanced stages due to nonspecific symptoms and anatomical location. Their proximity to critical structures complicates both surgery and radiotherapy. While multimodal treatment is standard, the role of chemotherapy remains unclear. Advances in molecular profiling have revealed alterations with prognostic and therapeutic relevance, highlighting the need for continued research to enhance treatment strategies. This review was based on all available prospective and retrospective studies, case reports, and review articles published up to May 2025 in PubMed. This article gives an overview of the current knowledge, showing the histological diversity of this area. In this context, we analyze the more recent data on different local treatment options: open and endoscopic surgery, photon and particles bean radiotherapy. We also discuss the role and timing of chemotherapy approaches. Advances in molecular characterization begin to define new pathological entities that will further improve in future years. Although clinical management of these rare diseases has been improved in recent years, ongoing research investigating the role of chemotherapy in these rare entities is of paramount importance to define appropriate and effective treatment regimens.