The evaluation of radiotherapy after incomplete surgery in patients with carcinoma of the maxillary sinus.
The retrospective analysis of 57 patients with cancer of the maxillary antrum irradiated after incomplete surgery was performed. The majority of patients had very advanced disease (54% T4 tumors). In 18 patients partial resection of maxillary antrum was performed: 39 patients underwent total maxillectomy. In 35 patients macroscopic residual tumor (MRT) was present after surgery. All patients were irradiated postoperatively with 60Co teletherapy and received a dose of 60 Gy in 20-30 fractions over 4-6 weeks. Five year symptom-free survival in the whole group was 35%. Significantly better survival was found in patients with T2 tumors in comparison with patients with T3 and T4 tumors, in patients with infrastructural localization in comparison with patients with suprastructural localization and in patients with microscopic residual tumor in comparison with MRT patients. An analysis of pattern of relapses indicates that histology should be regarded as an important factor of management. In keratinizing squamous cell cancer, local control remains the main problem. In patients with nonkeratinizing squamous cell cancer, both local and regional control is important and elective irradiation of neck nodes may be of value. In patients with undifferentiated cancer, distant metastases appear to have the greatest impact on survival.
Korzeniowski
S
S
Reinfuss
M
M
Skołyszewski
J
J
D000230:Adenocarcinoma / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000532:radiotherapy / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008444:Maxillary Sinus Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy*; D011867:Radioisotope Teletherapy
D003037:Cobalt Radioisotopes