Results of multimodality therapy for squamous cell carcinoma of maxillary sinus

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

Squamous cell carcinoma of the maxillary sinus: A Tata Memorial Hospital experience

“…Similarly, use of preoperative radiotherapy with concomitant intra-arterial chemotherapy has been reported with improved outcomes, but larger studies are needed to confirm these results. [1,5,[15][16] In this study ten of 62 patients had disease failure in the cervical lymph nodes. The role of elective neck treatment is also debatable.…”

Impact of Superselective Transarterial Infusion Therapy of High-Dose Cisplatin on Maxillary Cancer with Orbital Invasion

“…[10][11][12][13][14] In conventional trimodal therapy, the 5-year survival rate was found to be approximately 50% in patients with T4, 2,3 while in previously reported intra-arterial infusion therapy studies, the 5-year survival rate was 56%-67% in patients with T4. [10][11][12][13][14] Intra-arterial infusion therapy can enhance intratumoral concentration of cisplatin, compared with systemic chemotherapy, and even positively affects cisplatin resistance. [15][16][17] Compared with the intra-arterial infusion therapy previously reported, our treatment was performed much more frequently and the location of the tip of the catheter may have been more appropriate and constant.…”

“…Previous reports described that the preservation rate of the orbital component was 67% by using intra-arterial infusion of 5-fluorouracil and cisplatin. 13 The reason that the orbital tumor was controlled well, even though infusion therapy was not performed from the ophthalmic artery, was because feeding from the ophthalmic artery is a parasitic supply, which probably decreases gradually as the tumor shrinks following cisplatin infusion therapy from the internal maxillary artery. We believe that parasitic supplies scarcely contribute to feeding of tumors when the blood supply from the internal maxillary artery becomes sufficient for the tumor's needs.…”

Intra-arterial chemoradiotherapy for head and neck cancer

“…Wide resection and reconstructive surgery have recently become popular, resulting in a decrease in the popularity of trimodality therapy. However, modifications of the trimodality therapy by Sato have been used as organ preservation therapy until recently (15)(16)(17), with Nishino, a direct heir of Sato's methods, reporting excellent results. His method includes 20 Gy irradiation, 5-FU IA infusion and minimally invasive surgery.…”