Ozsaran Zeynep, Yalman Deniz, Baltalarli Bahar, Anacak Yavuz, Esassolak Mustafa, Haydaroğlu Ayfer
Ege University, Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey.
Rhinology. 2003 Mar;41(1):44-8.
The aim of this study is to evaluate the outcome of patients with maxillary sinus carcinoma after radiotherapy regarding local control, prognostic factors and morbidity of treatment.
Between January 1983 and December 1996, 79 cases of maxillary sinus carcinoma without any evidence of distant metastases, were treated with radiotherapy.
Fifty-two patients (65.8%) were male and 27 (34.2%) were female. The median age was 57. Histologically 62% were epidermoid carcinoma, 32.9% were non-epidermoid carcinoma and 5.1% were unclassified. Sixteen patients (20.5%) had T2, 25 (29.8%) had T3 and 38 (49.7%) had T4 tumour while 13 patients (16.5%) had lymph node metastases. Fifty-nine patients (74.4%) underwent surgical resection followed by postoperative radiotherapy and 20 patients (25.3%) received radiotherapy alone. The median follow-up was 71 months; 5-year overall survival and local control rates were 53% and 54% respectively. Prognostic factors influencing the overall survival were histologic type (epidermoid carcinoma, p = 0.02), advanced T stage (p = 0.04), postoperative residual tumour (p = 0.002) and lymph node involvement (p = 0.01) whereas the factors influencing local control were histologic type (p = 0.05) and postoperative residual tumour (p = 0.005). Late radiation morbidity were cataract (11.4%), loss of vision (8.9%), trismus (5.1%) and hearing loss (2.5%).
In maxillary sinus carcinomas high rates of local control can be achieved with surgery and radiotherapy. Postoperative radiotherapy can have a positive impact on local control and overall survival especially in patients with early stage tumour of non-epidermoid histology and without residual disease after surgery.
本研究旨在评估上颌窦癌患者放疗后的局部控制情况、预后因素及治疗相关并发症。
1983年1月至1996年12月期间，79例无远处转移证据的上颌窦癌患者接受了放射治疗。
52例（65.8%）为男性，27例（34.2%）为女性。中位年龄为57岁。组织学类型方面，62%为表皮样癌，32.9%为非表皮样癌，5.1%为未分类。16例（20.5%）患者为T2期，25例（29.8%）为T3期，38例（49.7%）为T4期肿瘤，13例（16.5%）有淋巴结转移。59例（74.4%）患者接受了手术切除并术后放疗，20例（25.3%）患者仅接受放疗。中位随访时间为71个月；5年总生存率和局部控制率分别为53%和54%。影响总生存的预后因素为组织学类型（表皮样癌，p = 0.02）、T分期较晚（p = 0.04）、术后残留肿瘤（p = 0.002）和淋巴结受累（p = 0.01），而影响局部控制的因素为组织学类型（p = 0.05）和术后残留肿瘤（p = 0.005）。晚期放疗并发症包括白内障（11.4%）、视力丧失（8.9%）、张口受限（5.1%）和听力丧失（2.5%）。
在上颌窦癌中，手术和放疗可实现较高的局部控制率。术后放疗对局部控制和总生存可能有积极影响，尤其是对于非表皮样组织学类型的早期肿瘤且术后无残留疾病的患者。
