局所進行上顎洞扁平上皮癌の治療成績

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  • Clinical Analysis of Patients with Locally Advanced Squamous Cell Carcinoma of the Maxillary Sinus
  • キョクショ シンコウ ジョウガクドウ ヘンペイ ジョウヒ ガン ノ チリョウ セイセキ

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<p>At our department, we performed a modified trimodal treatment (MTT) in patients with locally advanced squamous cell carcinoma of the maxillary sinus for improving the rates of preservation of the palate and eyeball between 1991 and 1997. This modified treatment, first reported by Sato, et al., is performed as a preoperative treatment and the residual tumor is removed subsequently. Furthermore, superselective cisplatin intraarterial infusion chemoradiotherapy (RADPLAT), proposed by Robbins et al., has been performed for further improving the rates of preservation of organs and functions since 1998. The 5-year palate-preserved survival rates in patients who received MTT (MTT group: n = 32) and RADPLAT (RADPLAT group: n = 68) were 22.8% and 42.4%, respectively. The 5-year eyeball-preserved survival rates in the patients who received MTT and RADPLAT were 31.9% and 54.1% (P = 0.006), respectively. Furthermore, the 5-year palate-preserved survival rates in patients with T4 tumors treated by MTT and RADPLAT were 17.3% and 28.0% (P = 0.003), respectively, and the eyeball-preserved survival rates were 24.6% and 40.9%, (P = 0.006) respectively. Organ and functional preservation were improved following introduction of RADPLAT, but the 5-year local control rates in the MTT group and RADPLAT group were 70.2% and 64.7% (P = 0.412), respectively, and the 5-year overall survival rates were 48.4% and 61.4% (P = 0.470), respectively, neither of which differed significantly between the MTT and RADPLAT groups. Modalities to achieve favorable local control and prolong overall survival while preserving organs and functions remain to be investigated in future studies.</p>

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