MAXILLARY SINUS CARCINOMAS - NATURAL-HISTORY AND RESULTS OF POSTOPERATIVE RADIOTHERAPY

被引:123
作者
JIANG, GL [1 ]
ANG, KK [1 ]
PETERS, LJ [1 ]
WENDT, CD [1 ]
OSWALD, MJ [1 ]
GOEPFERT, H [1 ]
机构
[1] UNIV TEXAS,MD ANDERSON CANCER CTR,DEPT HEAD & NECK SURG,HOUSTON,TX 77030
关键词
MAXILLARY SINUS CARCINOMA; SURGICAL EXCISION; PALPABLE LYMPHADENOPATHY; POSTOPERATIVE RADIOTHERAPY;
D O I
10.1016/0167-8140(91)90037-H
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Between 1969 and 1985, 73 patients with maxillary sinus cancers underwent surgical excision and postoperative radiotherapy. The clinical stage distribution by the AJC system was 3 T1, 16 T2, 32 T3, and 22 T4. Six patients had palpable lymphadenopathy at diagnosis. Surgery for the primary tumor consisted of partial or radical maxillectomy, and if disease stage indicated it, ipsilateral orbital exenteration. This was followed by radiation treatment delivered through a wedge-pair or three-field technique. All but three patients received 50-60 Gy in 2 Gy fractions to an isodose line defining the target volume. Elective neck irradiation was not routinely given. Clinically involved nodes were treated with definitive radiotherapy (five patients) or combined treatment (one patient). Forty-five patients had no evidence of disease at the last follow-up. The 5-year relapse-free survival for the whole group was 51% The overall local control rate was 78%. Patients with larger tumors, particularly if they also had histological signs of nerve invasion, had a higher recurrence rate than others. The overall nodal recurrence rate without elective neck treatment was 38% for squamous and undifferentiated carcinoma, and only 5% for adenoid cystic carcinomas. Therefore, our current recommendation is to deliver elective nodal irradiation routinely to patients with squamous or undifferentiated carcinoma, except for those who have T1 lesions. Treatment complications were vision impairment, brain and bone necrosis, trismus, hearing loss, and pituitary insufficiency. The incidence of major side effects was determined by disease extent and treatment technique. Many technical refinements were introduced in order to limit the dose to normal tissues in an attempt to reduce the complication rate. To what extent such practice influences the outcome will be determined from subsequent analysis.
引用
收藏
页码:193 / 200
页数:8
相关论文
共 27 条
[1]   CARCINOMA OF THE MAXILLARY ANTRUM - SURGERY OR RADIATION-THERAPY [J].
AMENDOLA, BE ;
EISERT, D ;
HAZRA, TA ;
KING, ER .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1981, 7 (06) :743-746
[2]  
BEALE FA, 1983, J OTOLARYNGOL, V12, P377
[3]  
BERKSON J, 1950, P STAFF M MAYO CLIN, V25, P270
[4]  
BUSH SE, 1982, CANCER, V50, P154, DOI 10.1002/1097-0142(19820701)50:1<154::AID-CNCR2820500129>3.0.CO
[5]  
2-W
[6]  
Edwards MWC, 1980, RAD DAMAGE NERVOUS S, P129
[7]  
FLETCHER GH, 1980, TXB RADIOTHERAPY, P408
[8]   TREATMENT OF ADVANCED SQUAMOUS CARCINOMA OF THE MAXILLARY SINUS BY IRRADIATION [J].
FRICH, JC .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1982, 8 (08) :1453-1459
[9]   MALIGNANT-TUMORS OF THE PARA-NASAL SINUSES AND NASAL CAVITY - A SERIES OF 180 PATIENTS [J].
GADEBERG, CC ;
HJELMHANSEN, M ;
SOGAARD, H ;
ELBROND, O .
ACTA RADIOLOGICA ONCOLOGY, 1984, 23 (2-3) :181-187
[10]  
HOPKIN NH, 1984, J LARYNGOL OTOL, V98, P589