Waldron J N, O'Sullivan B, Gullane P, Witterick I J, Liu F F, Payne D, Warde P, Cummings B
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, 610 University Ave., Toronto, Ontario, M5G 2M9, Canada.
Radiother Oncol. 2000 Nov;57(2):167-73. doi: 10.1016/s0167-8140(00)00256-5.
Cancer of the maxillary antrum is a rare disease with a variety of treatment options. The present study was undertaken to review the outcome of patients with carcinoma of the maxillary antrum managed at a single institution.
A retrospective analysis of 110 cases of carcinoma of the maxillary antrum managed with curative intent during the time period 1976-1993 was performed. There were 33 females and 77 males; the median age was 64 years (range 38-89). The median follow-up time was 4 years (range from 2 months to 17 years). The majority of patients presented with locally advanced disease (78 T4 tumours); nodal involvement was observed in 17/110 cases. Histologic subtypes included in the analysis were limited to squamous cell carcinoma (95 cases) and undifferentiated carcinoma (15 cases). Patients were managed with either primary radiation therapy with surgery reserved for salvage (83/110) or with a planned combined approach with surgery and either pre or postoperative radiation (27/110).
The actuarial 5-year cause-specific survival rate was 43%. The 5-year local control rate was 42%. Of 63 patients with local failure, 25 underwent salvage surgery with a subsequent 5-year cause-specific survival of 31%. Multiple regression analysis of patient, disease and treatment related variables identified local disease extent and nodal disease at presentation as the only variables independently associated with cause-specific survival.
This analysis indicates that survival from carcinoma of the maxillary antrum is poor with outcome strongly related to local disease extent. The best treatment strategy for this disease remains undefined. Salvage surgery can result in prolonged survival in selected patients experiencing local failure.
上颌窦癌是一种罕见疾病，有多种治疗选择。本研究旨在回顾在单一机构接受治疗的上颌窦癌患者的治疗结果。
对1976年至1993年间以根治为目的治疗的110例上颌窦癌病例进行回顾性分析。其中女性33例，男性77例；中位年龄为64岁（范围38 - 89岁）。中位随访时间为4年（范围从2个月至17年）。大多数患者表现为局部晚期疾病（78例T4期肿瘤）；110例中有17例观察到有淋巴结受累。分析中纳入的组织学亚型仅限于鳞状细胞癌（95例）和未分化癌（15例）。患者接受的治疗方式为：要么先行根治性放疗，将手术留作挽救性治疗（110例中的83例），要么采用计划性联合治疗，即手术联合术前或术后放疗（110例中的27例）。
精算5年病因特异性生存率为43%。5年局部控制率为42%。63例局部复发患者中，25例接受了挽救性手术，随后的5年病因特异性生存率为31%。对患者、疾病和治疗相关变量进行的多元回归分析确定，就诊时的局部疾病范围和淋巴结疾病是与病因特异性生存独立相关的唯一变量。
该分析表明，上颌窦癌患者的生存率较低，其结果与局部疾病范围密切相关。该疾病的最佳治疗策略仍不明确。挽救性手术可使部分局部复发患者的生存期延长。
