Definitive radiotherapy with or without chemotherapy for T3-4N0 squamous cell carcinoma of the maxillary sinus and nasal cavity.
OBJECTIVE
To evaluate the efficacy and toxicity of definitive radiotherapy with or without chemotherapy for T3-4 squamous cell carcinoma of maxillary sinus and nasal cavity.


METHODS
Forty-two patients with T3-4N0 squamous cell carcinoma of maxillary sinus (n = 30) and nasal cavity (n = 12) received definitive radiotherapy. Chemotherapy was used in 34 patients and elective neck irradiation was not used.


RESULTS
The 5-year overall survival/local control rates were 34%/29% for maxillary sinus cancer and 50%/52% for nasal cavity cancer. For maxillary sinus cancers, a performance status of Eastern Cooperative Oncology Group >or=2 (P = 0.012), biologically equivalent dose <68 Gy (P = 0.011) and no use of chemotherapy (P = 0.037) were significant worse predictors for overall survival on log-rank analysis. Biologically equivalent dose <68 Gy was independently associated with poor local control (hazard ratio, 3.32; 95% confidence interval, 1.38-7.97; P = 0.007) and overall survival (hazard ratio, 2.94; 95% confidence interval, 1.23-7.01; P = 0.015). Regional recurrence occurred in only 1 of 30 patients with maxillary sinus cancer and 4 of 12 patients with nasal cavity. Two radiation necrosis in brain, one osteoradionecrosis, and one retinopathy and optic neuropathy occurred.


CONCLUSIONS
The treatment outcome was poor and local control was a major problem. High radiation dose, effective chemotherapy and elective neck irradiation for advanced nasal cavity cancers may improve disease control.
Jang
Na Young
NY
Department of Radiation Oncology, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, 110-744 Seoul, Republic of Korea. wuhg@snu.ac.kr
Wu
Hong-Gyun
HG
Park
Charn Il
CI
Heo
Dae-Seog
DS
Kim
Dong-Wan
DW
Lee
Se-Hoon
SH
Rhee
Chae-Seo
CS
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D009296:Nasal Cavity; D009669:Nose Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D010166:Palliative Care; D011379:Prognosis; D011832:Radiation Injuries; D015996:Survival Rate