Treatment of Maxillary Sinus Carcinoma

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  • 上顎洞癌の治療
  • ジョウガクドウガン ノ チリョウ

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In Japan, malignant tumors of the nasal-paranasal cavities account for very few of all tumors of the head and neck. Sixty-two percent of those nasal-paranasal cavity tumors consist of malignant tumors of the maxillary sinuses. The best therapeutic approach for this malignancy remains under discussion. The reason for this is that surgical excision of advanced maxillary sinus carcinoma often entails complicated resections, such as that of the orbital contents, facial skin and oral palate. Given this background, attempts are being made to design a multidisciplinary approach to the treatment of maxillary sinus carcinoma with the objective of obtaining both cure and function. The multidisciplinary approach includes low-dose radiotherapy, intra-arterial infusion of anticancer agents and surgical excision with a minimum safety margin. This paper reports on the indications and methodology of multidisciplinary therapy for maxillary sinus carcinoma currently being applied by the Department of Otolaryngology - Head and Neck Surgery of Jichi Medical University. The 5-year over-all survival rates and local control rates for squamous cell carcinoma were 73% and 72%, respectively. For only squamous cell carcinoma cases, the 5-year local control rates as a function of the T classification were 71% for T2, 88% for T3, 60% for T4a and 56% for T4b. Among patients with middle skull base involvement, local recurrence of carcinoma in the base of the skull occurred in 1 of the 9 patients with invasion to the round foramen, 1 of the 3 patients with invasion to the oval foramen and 2 of the 3 patients with invasion of the the lacerate foramen.

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