Treatment policy for maxillary sinus carcinoma

Some 908 cases of malignant tumors of the nose and paranasal sinuses treated from 1957 through 1974 were statistically analysed. The most common tumor site was the maxillary sinus (91.4%) and the most common histological figure was carcinoma (92.4%). The crude and relative survival rates for each treatment mode were calculated in January 1975. The number of cases and the 5 year relative survival rates of the main groups were as follows: I. Primary cases of malignant tumors (761 cases) 29.2% A. Carcinoma (709 cases) 29.3% B. Sarcoma (45 cases) 27.4% II. Primary cases of maxillary sinus carcinoma (561 cases) 26.1% A. Period 1957-66 (282 cases) 22.8% 1. Combination of irradiation and surgery (114 cases) 36.9% 2. Irradiation alone (168 cases) 12.7% B. Period 1967-69 (130 cases) 34.5% 1. Irradiation with 5-FU intra-arterial infusion (25 cases) 36.1% 2. Irradiation with intra-arterial infusion of other radiosensitizers (35 cases) 35.7% 3. Irradiation only without infusion (45 cases) 35.2% C. Period 1970-71, Linac X-ray irradiation (61 cases) 15.9% D. Period 1972-73, Irradiation with 5-FU infusion (80 cases), 3 year relative survival rate 39.3% The stage-grouping of maxillary sinus carcinoma based on the classification of tumor spread in the TNM system was recommended for the comparison of survival rates. The best mode of treatment in our experience is the combination of Co-60 gamma-ray irradiation and continuous intrarterial infusion of 5-FU. A curettage during irradiation is recommended. A maxillectomy should be performed only for irradiation failure cases.