title: Definitive radiotherapy with or without chemotherapy for T3-4N0 squamous cell carcinoma of the maxillary sinus and nasal cavity.
abstract: 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.
authors.affiliation: 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
authors.forename: Na Young
authors.initials: NY
authors.lastname: Jang
authors.forename: Hong-Gyun
authors.initials: HG
authors.lastname: Wu
authors.forename: Charn Il
authors.initials: CI
authors.lastname: Park
authors.forename: Dae-Seog
authors.initials: DS
authors.lastname: Heo
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Kim
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Chae-Seo
authors.initials: CS
authors.lastname: Rhee
mesh_terms: 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