Department of Radiation Oncology, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, 110-744 Seoul, Republic of Korea.
Jpn J Clin Oncol. 2010 Jun;40(6):542-8. doi: 10.1093/jjco/hyq009. Epub 2010 Feb 25.
To evaluate the efficacy and toxicity of definitive radiotherapy with or without chemotherapy for T3-4 squamous cell carcinoma of maxillary sinus and nasal cavity.
Forty-two patients with T3-4N0 squamous cell carcinoma of maxillary sinus (n = 30) and nasal cavity (n = 12) received definitive radiotherapy. Chemotherapy was used in 34 patients and elective neck irradiation was not used.
The 5-year overall survival/local control rates were 34%/29% for maxillary sinus cancer and 50%/52% for nasal cavity cancer. For maxillary sinus cancers, a performance status of Eastern Cooperative Oncology Group >or=2 (P = 0.012), biologically equivalent dose <68 Gy (P = 0.011) and no use of chemotherapy (P = 0.037) were significant worse predictors for overall survival on log-rank analysis. Biologically equivalent dose <68 Gy was independently associated with poor local control (hazard ratio, 3.32; 95% confidence interval, 1.38-7.97; P = 0.007) and overall survival (hazard ratio, 2.94; 95% confidence interval, 1.23-7.01; P = 0.015). Regional recurrence occurred in only 1 of 30 patients with maxillary sinus cancer and 4 of 12 patients with nasal cavity. Two radiation necrosis in brain, one osteoradionecrosis, and one retinopathy and optic neuropathy occurred.
The treatment outcome was poor and local control was a major problem. High radiation dose, effective chemotherapy and elective neck irradiation for advanced nasal cavity cancers may improve disease control.
评估放化疗与单纯放疗治疗 T3-4 期上颌窦和鼻腔鳞状细胞癌的疗效和毒性。
42 例 T3-4N0 期上颌窦（n=30）和鼻腔（n=12）鳞状细胞癌患者接受根治性放疗。34 例患者接受化疗，不进行选择性颈部照射。
上颌窦癌的 5 年总生存率/局部控制率为 34%/29%，鼻腔癌为 50%/52%。对于上颌窦癌，东部肿瘤协作组体能状态≥2（P=0.012）、生物等效剂量<68Gy（P=0.011）和未使用化疗（P=0.037）是总生存的对数秩分析中显著较差的预测因素。生物等效剂量<68Gy 与局部控制不良（风险比，3.32；95%置信区间，1.38-7.97；P=0.007）和总生存不良（风险比，2.94；95%置信区间，1.23-7.01；P=0.015）独立相关。仅 1 例上颌窦癌患者和 4 例鼻腔癌患者出现区域性复发。发生 2 例放射性脑坏死、1 例骨放射性坏死和 1 例视网膜病变和视神经病变。
治疗结果较差，局部控制是主要问题。对于晚期鼻腔癌，高剂量放疗、有效的化疗和选择性颈部照射可能会改善疾病控制。
