title: Influence of postsurgical residual tumor volume on local control in radiotherapy for maxillary sinus cancer.
abstract: BACKGROUND
  The aim was to study the influence of postsurgical gross residual tumor volume on local control of maxillary sinus cancer treated with radiotherapy combined with debulking surgery.
  
  
  METHODS
  Forty-three patients who underwent combined surgery and radiotherapy (50-72 Gy, median 60 Gy) for squamous cell carcinoma of the maxillary sinus were reviewed. Gross residual tumor volume (GRTV) after surgery was measured on computed tomograms obtained during the radiotherapy planning. Patients were classified according to GRTV as follows: group AA, GRTV = 0 (microscopic residual, n = 2); group A, GRTV < 10 cm3 (n = 24); group B, 10-40 cm3 (n = 9); and group C, > or = 40 cm3 (n = 8). The relationship between local control and GRTV was analyzed using univariate and multivariate analysis.
  
  
  RESULTS
  The 2-year local control rate for all patients was 62%. The differences in local control rates between groups AA, A and B were not significant (P > 0.05), but the rate was significantly lower in group C than in the other groups (69% at 2 years vs 31% at 1 year, P < 0.001). Multivariate analysis showed that GRTV (P = 0.002) and histological differentiation (poorly differentiated histology was favorable, P = 0.035) were independent prognostic factors and that intra-arterial chemotherapy and administered total dose were not. Local control in groups A and B significantly depended on the total dose of radiotherapy, with 2-year control rates of patients receiving 50 Gy (n = 6) and > or = 60 Gy (n = 27) of 17% vs 79%, respectively (P < 0.001).
  
  
  CONCLUSIONS
  Our data suggest that adequate, not complete, debulking associated with a total radiotherapy dose of > or = 60 Gy can provide satisfactory local control for patients with squamous cell carcinoma of the maxillary sinus.
authors.affiliation: Department of Radiology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. mkawashi@east.ncc.go.jp
authors.forename: M
authors.initials: M
authors.lastname: Kawashima
authors.forename: T
authors.initials: T
authors.lastname: Ogino
authors.forename: R
authors.initials: R
authors.lastname: Hayashi
authors.forename: S
authors.initials: S
authors.lastname: Ishikura
authors.forename: K
authors.initials: K
authors.lastname: Nihei
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: H
authors.initials: H
authors.lastname: Ikeda
authors.forename: S
authors.initials: S
authors.lastname: Ebihara
authors.forename: Y
authors.initials: Y
authors.lastname: Itai
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008443:Maxillary Sinus / Q000601:surgery*; D008444:Maxillary Sinus Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D018365:Neoplasm, Residual; D011184:Postoperative Period; D011879:Radiotherapy Dosage