Sakashita Tomohiro, Homma Akihiro, Hatakeyama Hiromitsu, Kano Satoshi, Mizumachi Takatsugu, Furusawa Jun, Yoshida Daisuke, Fujima Noriyuki, Onimaru Rikiya, Tsuchiya Kazuhiko, Yasuda Koichi, Shirato Hiroki, Suzuki Fumiyuki, Fukuda Satoshi
Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Br J Oral Maxillofac Surg. 2014 Apr;52(4):323-8. doi: 10.1016/j.bjoms.2014.01.018. Epub 2014 Feb 26.
Our aim was to evaluate the feasibility of salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy. We retrospectively analysed the records of 61 patients with cancer of the maxillary sinus who were treated in this way. Chemotherapy comprised 100-120 mg/m(2) superselective intra-arterial infusions of cisplatin given a median of 4 times weekly (range 2-5). Concurrent radiotherapy was given in a median dose of 65 Gy (range 24-70 Gy). Persistent or recurrent cancer of the maxillary sinus was found in 17 patients, of whom 11 had salvage surgery. The disease was controlled in 8 of the 11, and 7 of the 11 survived with no evidence of disease. Their 5-year overall survival was 61%. Two of the 11 developed serious operative complications. Salvage surgery for patients with persistent or recurrent cancer of the maxillary sinus treated by superselective chemoradiotherapy is both safe and successful. Salvage surgery is a good option when this sort of persistent or recurrent cancer is followed up after the regimen of chemoradiotherapy described.
我们的目的是评估对上颌窦癌患者在超选择性动脉内输注顺铂并同步放疗后出现持续性或复发性癌症时进行挽救性手术的可行性。我们回顾性分析了61例接受这种治疗的上颌窦癌患者的记录。化疗包括以100 - 120 mg/m²的剂量超选择性动脉内输注顺铂,中位给药频率为每周4次(范围为2 - 5次)。同步放疗的中位剂量为65 Gy(范围为24 - 70 Gy)。17例患者出现上颌窦持续性或复发性癌症,其中11例接受了挽救性手术。11例中有8例疾病得到控制,11例中有7例存活且无疾病证据。他们的5年总生存率为61%。11例中有2例出现严重手术并发症。对于接受超选择性放化疗治疗后出现上颌窦持续性或复发性癌症的患者,挽救性手术既安全又成功。当按照所述放化疗方案对这种持续性或复发性癌症进行随访时,挽救性手术是一个不错的选择。