[Intra-arterial chemotherapy of maxillary sinus carcinoma]

The long-term results and the preservation rate of maxillo-facial functions and structures were reviewed in 250 cases of maxillary sinus carcinoma which were treated at the Department of Otolaryngology of Keio University Hospital from 1957 to 1987, dividing them into 4 groups according to treatment modalities. The major treatment modalities of each group are as follows. I (1957-1966): Half of the cases underwent radical resection of the maxillo-facial region with or without postoperative irradiation. Preoperative intra-arterial chemotherapy was first introduced in 1963. II (1967-1973): Half of the cases received preoperative intra-arterial chemotherapy with bleomycin (BLM). III (1974-1981): The major treatment modalities consist of BLM ia + radiation----surgery and 5-FU ia + radiation. IV (1982-1987): Multidisciplinary treatment incorporating intra-arterial neoadjuvant chemotherapy mainly with cisplatin and peplomycin was performed. The 5-year survival rates of each group are as follows. I: 22%, II: 40%, III: 42%, IV: 55%. The 5-year survival rate was as high as 52% in cases treated with BLM ia followed by surgery in group II, but all cases underwent total maxillectomy. Meanwhile, in group IV, the 5-year survival rate was not only as high as 55%, but also the rate of total maxillectomy was quite low (18%). From these results, we realized that intra-arterial chemotherapy played an important role for improving the long-term results and preserving the functions and structures in the treatment of maxillary sinus carcinoma.