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Trimodal combination therapy for maxillary sinus carcinoma.
Ryo-ichi Yoshimura1, Hitoshi Shibuya, Ichiro Ogura
1Department of Radiology, Tokyo Medical and Dental University, 5-45 Yushima I-chome, Bunkyo-ku, Tokyo 113-8519, Japan. ysmrmrad@med.tmd.ac.jp
Summary
Trimodal combination therapy shows promise for maxillary sinus carcinoma, with outcomes influenced by tumor stage and 5-fluorouracil (5-FU) dosage. Achieving good local control is possible with this treatment approach.
Area of Science:
- Oncology
- Head and Neck Surgery
Background:
- Maxillary sinus carcinoma presents a complex treatment challenge.
- Trimodal combination therapy, integrating radiotherapy, intra-arterial chemotherapy, and antrotomy, is a treatment modality explored for this condition.
Purpose of the Study:
- To evaluate the effectiveness of trimodal combination therapy for primary maxillary sinus carcinoma.
- To assess survival and local control rates in patients treated with this approach.
Main Methods:
- A cohort of 110 patients with maxillary squamous cell carcinoma treated between 1977 and 1996 were analyzed.
- Tumors were staged using the UICC TNM system, with a focus on T3 and T4 classifications and tumor location (posterior-lateral, medial, upper).
- Patients received trimodal therapy, with some undergoing additional radiotherapy or surgery.
Main Results:
- The 5-year cause-specific survival and local control rates were 71% and 65%, respectively.
- Local control rates varied by T stage (80% for T1+2, 64% for T3, 52% for T4).
- Higher 5-fluorouracil (5-FU) dosage (>3500 mg) correlated with improved local control in specific tumor locations (p=0.01).
Conclusions:
- Trimodal combination therapy offers effective local control for maxillary sinus carcinoma.
- Tumor stage (T stage) and 5-FU dosage are critical determinants of treatment outcomes.
- Further optimization of chemotherapy dosage may enhance treatment efficacy.