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Outcomes of radiation therapy for maxillary sinus carcinoma
Authors:Komiyama Takafumi  Onishi Hiroshi  Kuriyama Kengo  Tanaka Shiho  Araki Tsutomu  Kato Daiki  Hara Ryusuke  Itami Jun
Institution:Department of Radiology, Yamanashi University School of Medicine.
Abstract:PURPOSE: We evaluated the outcome of radiation therapy for maxillary sinus carcinoma treated in our institution. MATERIALS AND METHODS: From 1984 to 2001, 48 patients with maxillary sinus carcinoma were irradiated with or without chemotherapy and surgery. Patients ranged from 20-89 years of age (median, 68 years) and included 29 men and 19 women. The clinical T factors for these patients, according to the UICC classification (1997), were T2(n = 2), T3(n = 13), and T4(n = 29). Lymph node involvement was observed in 13 patients. The follow-upperiod ranged from 2.5 to 150 months (median, 25 months). The total radiotherapy dose ranged from 40 Gy to 72.8 Gy. Forty-three patients underwent surgery. Intra-arterial chemotherapy was delivered in 39 patients, and systemic chemotherapy was delivered in 7 patients. Fourteen patients were classified as "unresected" (radiation therapy with or without antrostomy), and 34 patients as "resected" (partial, total, or extended total maxillectomy with pre- or postoperativeirradiation). RESULTS: The 5-year overall survival rate(OS), cause-specific survival rate(CSS), and local control rate(LC) of all patients were 52%, 64%, and 75%, respectively. There was no significant difference between the "uaresected" and "resected" groups in OS, CSS, or LC. Local recurrence was observed in 12 patients. In the "resected" group, for local control, it was important to reduce viable tumor before maxillectomy. Preoperative > or = 60 Gy irradiation was considered to be effective to reduce tumor viability. CONCLUSION: There was no significant difference between the "unresected" and "resected" groups in OS, CSS, or LC. In the "resected" group, preoperative irradiation > or = 60 Gy was considered to be effective for local control. In radical treatment of maxillary sinus carcinoma, maxillectomy is not always necessary. Concurrent chemoradiation therapy with or without antrostomy is a reasonable treatment strategy.
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