[Multidisciplinary treatment of maxillary cancer]

Cases of maxillary cancer treated at our institute can be divided into two groups. In the first group (1971-1982, N = 85), we treated maxillary cancer by preoperative intraarterial infusion of 5-FU and Linac X-ray irradiation (60 Gy/6 weeks), followed by maxillectomy. In the second group (1982-1986, N = 32), we further combined intraarterial or intravenous chemotherapy using CDDP preoperatively or postoperatively depending upon the stage of the cancer. Five-year survival rate was 64.7% in the first group and 73.9% in the second. In the first group, the most frequent cause of death was distant metastasis without local recurrence. In the second group, the histopathological effect of chemotherapy and radiotherapy was improved with a reduced frequency of distant metastasis and it has now become possible to have 5-year survivors from among N2 and M1 cases. Judging from the histopathological effects of chemotherapy and radiotherapy, it seems possible to treat T2 and some T3 cases of maxillary cancer without performing maxillectomy. However, in T4 and most of T3 cases in which early recurrence is difficult to detect, it seems safer to combine total maxillectomy primarily.