Combined surgery, radiotherapy and regional chemotherapy in carcinoma of the maxillary sinus.
In order to avoid post-operative cosmetic and functional disabilities, we introduced simultaneous surgery, radiotherapy and regional chemotherapy in treating carcinomas of the maxillary sinus in October 1964 and have been working to perfect this procedure ever since. This combined therapy consists of 1) a "reduction operation," i.e., reduction of the tumor mass, succeeded by daily cleaning of the residual tumor, 2) six external irradiation (mean dose is 1,200 rads/over a period of nine days) treatments and 3) five intra-arterial infusions of 5-fluorouracil (5-FU) (250 mg daily) and broxuridine (BUdR) (500 mg daily). The degenerative changes of the tumor cells, as observed by histopathological examinations, appear so rapidly that, when six irradiation treatments and five infusions were given, 80% of the cases showed marked irreversible change. This degeneration is not affected by the degree of differentiation. In other words, no variation was observed between well and poorly differentiated squamous cell carcinomas. In 77 cases infused with 5-FU alone, the five-year survival rate was 55%. Seventy-six percent of 45 cases infused with BUdR as well as 5-FU were still living after five years. We want to emphasize that these survivors are able to return to normal life with their eyes and palates well rehabilitated.
D001973:Bromodeoxyuridine / Q000627:therapeutic use; D002277:Carcinoma / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007269:Injections, Intra-Arterial; D008443:Maxillary Sinus; D008722:Methods; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
D001973:Bromodeoxyuridine; D005472:Fluorouracil