上顎癌再発症例の処置について

概要

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Clinical observations were made on 10 patients with maxillary tumors who had been treated with the combined therapy of necrotomy, irradiation and regional chemotherapy since 1970. All 10 patients had a recurrence within seven months after the combined therapy. As a secondary therapy, five patients were managed by conservative therapy and five underwent a total maxillectomy. Four are now living and well from three months to eight years following the secondary therapy of the total maxillectomy, re-irradiation and cryosurgery with no evidence of recurrence. One patient is living eleven months following the secondary therapy of infusion of 210mg of Bleomycin through the superior thyroid artery and re-irradiation of 2500 rads, but a biopsy of the anterior wall of the antrum was found to be positive for cancer. Five died of local recurrence within one year.If the recurrence is localized at the anterior wall and the posterior wall of the antrum, a total maxillectomy should be performed. If the recurrence is localized on the lateral wall, the medial and inferior walls of the antrum, conservative therapy with necrotomy after a period of cryosurgery, intraarterial infusion of anticancer drugs, re-irradiation and anticancerous ointment should be considered.
耳鼻咽喉科臨床学会の論文