Konno A, Hanazawa S, Okamoto Y, Shimada K, Terada N, Togawa K, Kato T
Gan To Kagaku Ryoho. 1987 Jun;14(6 Pt 1):1772-80.
Cases of maxillary cancer treated at our institute can be divided into two groups. In the first group (1971-1982, N = 85), we treated maxillary cancer by preoperative intraarterial infusion of 5-FU and Linac X-ray irradiation (60 Gy/6 weeks), followed by maxillectomy. In the second group (1982-1986, N = 32), we further combined intraarterial or intravenous chemotherapy using CDDP preoperatively or postoperatively depending upon the stage of the cancer. Five-year survival rate was 64.7% in the first group and 73.9% in the second. In the first group, the most frequent cause of death was distant metastasis without local recurrence. In the second group, the histopathological effect of chemotherapy and radiotherapy was improved with a reduced frequency of distant metastasis and it has now become possible to have 5-year survivors from among N2 and M1 cases. Judging from the histopathological effects of chemotherapy and radiotherapy, it seems possible to treat T2 and some T3 cases of maxillary cancer without performing maxillectomy. However, in T4 and most of T3 cases in which early recurrence is difficult to detect, it seems safer to combine total maxillectomy primarily.
我院收治的上颌窦癌病例可分为两组。第一组(1971 - 1982年,N = 85),我们采用术前动脉内灌注5 - 氟尿嘧啶及直线加速器X线照射(60 Gy/6周),随后行上颌骨切除术治疗上颌窦癌。第二组(1982 - 1986年,N = 32),我们根据癌症分期在术前或术后进一步联合使用顺铂进行动脉内或静脉化疗。第一组的5年生存率为64.7%,第二组为73.9%。在第一组中,最常见的死亡原因是远处转移而无局部复发。在第二组中,化疗和放疗的组织病理学效果得到改善,远处转移频率降低,现在N2和M1病例中出现5年生存者已成为可能。从化疗和放疗的组织病理学效果判断,对于T2和部分T3病例的上颌窦癌,似乎有可能不进行上颌骨切除术进行治疗。然而,对于难以早期发现复发的T4和大多数T3病例,似乎首先联合全上颌骨切除术更为安全。