목적: Sinonasal malignancies pose significant treatment challenges due to their proximity to critical structures like the orbit and brain. Despite the potential of induction chemotherapy (IC) to facilitate organ preservation and improve surgical outcomes, its comprehensive efficacy and impact on long-term outcomes remain inadequately explored. 방법:This retrospective analysis included 310 patients receiving definitive treatment for locally advanced sinonasal malignancies having T stage same or more than T3 at a single academic institution for 32years. The study assessed responsiveness and side effects of IC, comparing oncological outcomes including overall survival (OS) and recurrence- free survival (RFS) between patients who received IC followed by definitive therapy (n=67) and those treated solely with definitive therapy (n=243). Additionally, we focused specifically on the impact of IC on T-downstaging, surgical resectability, with initial and long- term organ preservation, according to initial T stage, cancer histology, and by responsiveness to IC. 결과:IC achieved a response rate of 61.2% across various cancer subtypes, with the rates of T-downstaging, surgical resectability, and initial organ preservation all ranging between 55% to 60%. Compared to non-IC patients, IC significantly reduced distant metastasis across cancer subtypes but did not enhance OS or RFS. Moreover, IC patients had significantly shorter duration for orbital recurrence thus increased eyeball exenteration over time than non-IC patients. Well-responders to IC demonstrated significantly improved OS, RFS, and final intracranial content preservation, but not final orbital preservation. 결론:While more than half of sinonasal cancer patients well respond to IC, enabling initial organ preservation, IC does not improve long- term survival or sustained organ preservation compared to definitive therapy alone.