Preoperative chemotherapy and radiation therapy for squamous cell carcinoma of the maxillary sinus.
OBJECTIVE
This study was undertaken to assess the prognostic factors for the management of squamous cell carcinoma (SCC) of the maxillary sinus, who received preoperative chemotherapy and radiation therapy (RT). We also elucidated the appropriate sequence of chemotherapy.


METHODS
A total of 124 patients (median age 62 years) with SCC of the maxillary sinus were analysed retrospectively. T3 or T4 disease was found in 93% of the patients. Thirty-nine patients received neoadjuvant chemotherapy (NA), 38 patients received concurrent chemoradiotherapy (CRT) and 47 patients received NA followed by CRT. The median dose of RT was 60 Gy. Maxillectomy was undertaken in 98 patients.


RESULTS
The 5 year overall survival (OAS) and local control probability (LCP) were 56.6 and 73.7%, respectively. On univariate analysis, surgery (P < 0.0001) and T classification (P < 0.04) were significant prognostic factors for OAS and LCP. Histological grade and nodal status were also related to OAS. However, any chemotherapy sequence was not associated with the treatment outcome. On multivariate analysis, surgery (P < 0.0005) and T classification (P < 0.05) were identified as significant prognostic factors for LCP and OAS.


CONCLUSIONS
This study suggests that both surgery and T stage are important prognostic factors for LCP and OAS in the management of SCC of the maxillary sinus. The appropriate sequence of chemotherapy remains to be elucidated in the future study.
Isobe
Koichi
K
Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba 260-8677, Japan. isobeko@ho.chiba-u.ac.jp
Uno
Takashi
T
Hanazawa
Toyoyuki
T
Kawakami
Hiroyuki
H
Yamamoto
Seiji
S
Suzuki
Homare
H
Iida
Yumiko
Y
Ueno
Naoyuki
N
Okamoto
Yoshitaka
Y
Ito
Hisao
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017663:Peplomycin / Q000008:administration & dosage; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
D017663:Peplomycin; D002945:Cisplatin; D005472:Fluorouracil