title: The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation.
abstract: The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3% (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2% (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan, t-sakashita@med.hokudai.ac.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakashita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hatakeyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kano
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Mizumachi
authors.forename: Jun
authors.initials: J
authors.lastname: Furusawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshida
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Fujima
authors.forename: Rikiya
authors.initials: R
authors.lastname: Onimaru
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Koichi
authors.initials: K
authors.lastname: Yasuda
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007261:Infusions, Intra-Arterial; D007564:Japan / Q000453:epidemiology; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009333:Neck; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents