From 1971 to 1983, a total of 208 patients with maxillary sinus carcinomas were treated at Department of Radiology, Hokkaido University School of Medicine, 38 by Method I (radiation + surgery + intraarterial 5-fluorouracil [5-Fu] infusion), and 170 by Method II (radiation + surgery). Radiation doses ranged from 30 to 50 Gy over 3 to 5 weeks in Method I and 52 to 58 Gy over 4 weeks in Method II. Overall actuarial survival rate at 5 years was 45.6%. No statistical difference in survival rates was found between Method I and Method II. With respect to T stage, absolute 5-year survival rates were 100% (4/4) for T2, 49.5% (52/105) for T3, and 24.4% (11/45) for T4. From our data, no advantage in the use of intra-arterial 5-Fu infusion was demonstrated; the local failures in Method I developed earlier and more frequently than in Method II. The ultimate failures for all patients were 46.8%. Since 1980 when treatment planning by using computerized tomography scans and immobilization device was initiated, improvement in survival rate while reducing an incidence of eye complications has been accomplished.
Treatment results were investigated in 113 previously untreated patients with clinical Stage I and II (Ann Arbor) non-Hodgkin's lymphoma of the head and neck. Fifty-six Waldeyer's ring, 34 other extranodal sites, and 23 cervical nodal lesions were included. The overall relapse-free survival at 5 years was 41%. Age and Ann Arbor stage influenced relapse-free survival. The results suggested that the tumor cell burden is a fundamental prognostic factor for patients with Waldeyer's ring disease and for patients with only cervical nodal disease. Abdominal relapse was most frequent, followed by generalized relapse. From 1981, patients were randomized in a clinical trial to receive either chemotherapy (cyclophosphamide, vincristine, and prednisone [CVP], five courses) or whole-abdominal irradiation (25 Gy/20 Fr) as an adjuvant therapy. Patients could not tolerate the whole-abdominal irradiation well. A significant improvement in survival has been obtained by adjuvant chemotherapy.
A total of 77 patients with nasopharyngeal carcinoma were retrospectively reviewed for the effectiveness of combining chemotherapy (CT) with radical radiotherapy (RT). From 1972 to 1976, 26 patients were treated with a relatively short course of radical RT alone: 52-55 Gy/16 Fx/4 wk (study 1). From 1977 to 1982, 29 patients were also treated with radical RT alone, but with a more prolonged fractionation schedule: 65-70 Gy/26-28 Fx/6.5-7 wk (study 2). In 1983, the policy was to combine CT and RT. From 1983 to 1987, 22 patients received four to six courses of CMU regimen (consisting of cyclophosphamide, methotrexate, and UFT, a 5-fluorouracil analog) after completion of radical RT (study 3). The three studies were comparable with regard to patient characteristics: histologic type, stage, sex, and age distribution. There were no significant differences in survival and relapse figures between study 1 and study 2, but study 3 compared favorably with study 1 and study 2 in actuarial survival, relapse-free survival, relapse rate, and median relapse time. A mild nausea and transient granulocytopenia during CT was the only side effect encountered. In conclusion, the use of CT in combination with RT appeared to increase significantly the chance of long-term survival and probable cure.
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