en Radiation Biology Radiation Biology مقاله مروری Review article <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Background:</span></span></span></span></span></span> <span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Sinonasal malignancies are rare, aggressive tumours with limited resectability and high recurrence due to complex anatomy and late presentation. Integrating neoadjuvant chemotherapy with programmed cell death protein 1 (PD-1)/ programmed cell death ligand 1 (PD-L1) blockade may enhance tumour regression and improve surgical outcomes. Adjuvant radiotherapy remains a critical component in disease control. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Materials and Methods: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">A narrative review was performed using PubMed, Scopus, and Web of Science (2010&ndash;2025). Search terms included Sinonasal Neoplasms, Neoadjuvant Therapy, Immunotherapy, and Radiotherapy. Studies on biological mechanisms, clinical outcomes of chemo-immunotherapy, and radiotherapy integration were included. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Results: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Evidence from emerging institutional series and extrapolation from head-neck oncology demonstrates that neoadjuvant chemo-immunotherapy promotes immunogenic cell death, enhances T-cell infiltration, and facilitates tumour downstaging. Early sinonasal cohorts report higher major pathological response, improved resectability, and acceptable safety. Adjuvant radiotherapy further augments locoregional control through antigen release and immune activation. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Conclusion: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Combining neoadjuvant chemo-immunotherapy with adjuvant radiotherapy is biologically rational and clinically promising for locally advanced sinonasal cancers. Prospective, biomarker-driven trials are needed to optimize sequencing and validate efficacy.</span></span></span></span></span></span></span></span></span></div> Sinonasal neoplasms, neoadjuvant therapy, immunotherapy, PD‑1, radiotherapy, adjuvant, Biomarkers. 901 908 http://ijrr.com/browse.php?a_code=A-10-1-1591&slc_lang=en&sid=1 Z. Zhu 7900319475328460034481 7900319475328460034481 No The Fourth School of Clinical Medicine，Zhejiang Chinese Medical University X. Lin 7900319475328460034482 7900319475328460034482 No The Fourth School of Clinical Medicine，Zhejiang Chinese Medical University J. Sun 7900319475328460034483 7900319475328460034483 No The Fourth School of Clinical Medicine，Zhejiang Chinese Medical University J. Zhu zhujin2698@hotmail.com 7900319475328460034484 7900319475328460034484 Yes Department of Otorhinolaryngology and Head Neck Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China