Nishino H, Miyata M, Morita M, Ishikawa K, Kanazawa T, Ichimura K
Department of Otolaryngology, Jichi Medical School, Tochigi, Japan.
Cancer. 2000 Nov 1;89(9):1925-32. doi: 10.1002/1097-0142(20001101)89:9<1925::aid-cncr8>3.3.co;2-8.
Current goals for the treatment of carcinoma of the maxillary sinus include the preservation of vision, ability to eat, ability to communicate, and appearance as well as cure.
Seventy-five Japanese patients who presented with maxillary sinus carcinoma between 1979 and 1997 were analyzed retrospectively. There were 48 males and 27 females with a median age of 62 years. The mean follow-up period was 73 months. All patients underwent multimodality therapy including surgery through a sublabial incision, radiotherapy, and regional chemotherapy. The regional lymph nodes were treated only in those patients with cervical lymph node involvement.
The 5-year and 10-year overall survival rates were 76% and 66%, respectively. In 65 patients with squamous cell carcinoma, the 5-year and 10-year overall survival rates were 77% and 66%, respectively. All 23 patients with orbital involvement retained the orbital contents and 17 patients demonstrated adequate ocular function. There was no disease recurrence reported among patients with involvement of the foramen rotundum or the foramen ovale, whereas two of the three patients with invasion of the foramen lacerum developed disease recurrence. There were 12 complications in 12 patients, including double vision (4 patients), cataracts (3 patients), trismus (4 patients), and fistula formation (1 patient).
Control of the primary tumor site is important in the curative treatment of patients with maxillary sinus carcinoma. Combined therapy with conservative surgery, radiotherapy, and regional chemotherapy appears to be an effective method for local control and the preservation of ocular function.
目前上颌窦癌的治疗目标包括保留视力、进食能力、沟通能力、外观以及实现治愈。
对1979年至1997年间出现上颌窦癌的75例日本患者进行回顾性分析。其中男性48例，女性27例，中位年龄62岁。平均随访期为73个月。所有患者均接受了多模式治疗，包括经唇下切口手术、放疗和区域化疗。仅对有颈部淋巴结受累的患者进行区域淋巴结治疗。
5年和10年总生存率分别为76%和66%。在65例鳞状细胞癌患者中，5年和10年总生存率分别为77%和66%。所有23例眼眶受累患者均保留了眼眶内容物，17例患者表现出足够的眼功能。圆孔或卵圆孔受累的患者未报告疾病复发，而3例破裂孔受侵患者中有2例出现疾病复发。12例患者出现12种并发症，包括复视（4例）、白内障（3例）、牙关紧闭（4例）和瘘管形成（1例）。
在治疗上颌窦癌患者时，控制原发肿瘤部位很重要。保守手术、放疗和区域化疗联合治疗似乎是局部控制和保留眼功能的有效方法。
