Combined therapy for maxillary sinus carcinoma with special reference to cryosurgery

Three hundred cases of maxillary sinus carcinoma were divided into four groups according to the initial treatment: the first group was treated by irradiation of 5,000 rad (25 fractions) for 5 weeks; the second by intra-arterial infusion of 5-FU combined with irradiation; the third by sinus curetting in accordance with Denker's operation combined with the second method; and the fourth by cryosurgery once a week during the second irradiation method followed by sinus curetting at the end of initial treatment. Histologically confirmed recurrence was removed by maxillectomy, if possible. The three year cumulative survival rates in the four groups were 27.1% (first group), 55.1% (second group), 53.5% (third group) and 53.1% (fourth group). The three year local non-recurrence rates after initial treatment without maxillectomy were 26.4%, 31.1%, 55.8% and 45.4%, respectively. The frequency of distant metastasis without local recurrence was as high as 12.3% in the third group and conversely 5.6% in the fourth. These results demonstrated the usefulness of cryosurgery.