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Keywords:

  • intraarterial chemotherapy;
  • radiation therapy;
  • skull base surgery;
  • regional chemotherapy;
  • maxillectomy

Abstract

BACKGROUND

A wide variety of modalities, including surgery, radiation therapy, and chemotherapy, alone or in combination, have been used for the treatment of squamous cell carcinoma (SCC) of the maxillary sinus to obtain better local control and maintain functions. However, there is still much controversy with regard to the optimum treatment.

METHODS

From 1987 to 1999, 33 patients with SCC of maxillary sinus were treated at the Department of Otolaryngology–Head and Neck Surgery, University of Tokyo Hospital. The treatment consisted of 30–40 grays (Gy) of preoperative radiotherapy with concomitant intraarterial infusion of 5-fluorouracil and cisplatin followed by surgery and 30–40 Gy of postoperative radiotherapy, for tumors without skull base invasion. For tumors invading the skull base, preoperative systemic chemotherapy with or without radiotherapy was performed, instead of intraarterial chemotherapy, then followed by skull base surgery. The surgical procedures varied according to the extent of tumor. Results were compared with those of the 108 patients treated in our hospital from 1976 to 1982.

RESULTS

Partial maxillectomy was performed in 2 T2 patients and 12 T3 patients. Total maxillectomy was performed in 1 T2 patient, 3 T2 patients, and 7 T4 patients. Skull base surgery was performed in eight T4 patients. Orbital content and hard palate were preserved in 22 patients and 18 patients, respectively. The overall 5-year survival rates were 86% in T 3 patients and 67 % in T4 patients, respectively.

CONCLUSIONS

Our multimodal treatment has provided favorable local control and survival outcome with good functional results. Cancer 2002;94:1476–82. © 2002 American Cancer Society.

DOI 10.1002/cncr.10253