上顎洞癌に対する集学治療の現状

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To avoid postoperative cosmetic and functional disabilities, treatment plans combining surgery, radiotherapy and regional chemotherapy were introduced for the treatment of maxillary sinus cancer in 1964. Since then, various refinements of multimodal treatment have been developed at several institution. In Japan, recent data indicate an average five-year survival rate exceeding 50%. However, preservation of function and figure, i. e. preservation of the hard palate and the eye, may not be achieved in most patients.The details of the multimodal treatment plans, such as the dose of radiation or the extent of surgery, differ considerably among various institutions. The quality of life of the survivors is strongly affected by the type of treatment. Currently, in most institutions the patient receives more than 50 Gy of radiation, followed by total maxillectomy. Although surgery plays an important role in multimodal treatment, total maxillectomy, which requires resection of the hard palate, is not always necessary. Preservation of the eye is an important consideration, however, a radiation dose in excess of 50 Gy results in the loss of vision.To improve the survivors' quality of life, various institutions have introduced changes in multimodal treatments for this type of cancer. For example, our treatment plan consists of a low irradiation dose of 24 Gy, combined with six fluorouracil intra-arterial infusions followed by piecemeal resection of the tumor, with the objective of preserving the eye and the hard palate. Although only 37 patients have been treated with this method, the five-year survival rate, as estimated by the Kaplan and Meier method, is 79%.
耳鼻咽喉科臨床学会の論文

上顎洞癌に対する集学治療の現状

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