Assistant Professor, Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.
Associate Professor, Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.
J Oral Maxillofac Surg. 2022 Aug;80(8):1445-1450. doi: 10.1016/j.joms.2022.04.014. Epub 2022 May 2.
Squamous cell carcinoma of the maxillary sinus (SCC-MS) is often diagnosed at a locally advanced stage, which is associated with poor prognosis. The purpose of the present study was to investigate clinical outcomes in patients with locally advanced T4 SCC-MS including originally inoperable T4b disease treated with neoadjuvant superselective intra-arterial chemoradiotherapy combined with surgery.
This study is a retrospective case series. We examined clinical outcomes in the patients with T4 SCC-MS between 2005 and 2017. The outcome variables were 5-year overall survival rate, 5-year disease-free survival rate, and 5-year local control rate. Covariates included age, sex, T classification, N classification, stage classification, type of surgery, number of administrations and total dose of cisplatin, and radiation dose. Descriptive statistics were computed for each study variable.
Ten patients with T4 SCC-MS (6 T4a and 4 T4b) were treated. All patients were men, and the median age was 60.5 years (range, 45 to 77). Total maxillectomy was performed in 4 patients, and extended total maxillectomy in 6. The total number of intra-arterial chemotherapy administrations ranged between 2 and 4 for patients with T4a disease and between 3 and 4 for those with T4b disease. The median intra-arterial cisplatin dose was 360 mg (range, 250 to 400) for patients with T4a disease and 360 mg (range, 320 to 480) for those with T4b disease. The 5-year overall survival, 5-year disease-free survival, and 5-year local control rates of all patients were 100%, 70%, and 80%, respectively. The 5-year disease-free survival rate and 5-year local control rate were 83% and 83%, respectively, in the 6 T4a patients and 50% and 75%, respectively, in the 4 T4b patients.
Neoadjuvant intra-arterial chemoradiotherapy in patients with T4 SCC-MS can achieve good clinical outcomes, and it may enable surgical resection of T4b lesions.
上颌窦鳞状细胞癌（SCC-MS）常被诊断为局部晚期，预后较差。本研究旨在探讨局部晚期 T4 SCC-MS 患者的临床结果，包括最初不能手术的 T4b 疾病患者，这些患者接受新辅助超选择性动脉内化疗和放疗联合手术治疗。
本研究为回顾性病例系列研究。我们研究了 2005 年至 2017 年间 T4 SCC-MS 患者的临床结果。研究的结果变量包括 5 年总生存率、5 年无病生存率和 5 年局部控制率。协变量包括年龄、性别、T 分类、N 分类、分期分类、手术类型、顺铂的给药次数和总剂量以及放射剂量。对每个研究变量进行描述性统计。
10 例 T4 SCC-MS（6 例 T4a 和 4 例 T4b）患者接受了治疗。所有患者均为男性，中位年龄为 60.5 岁（范围为 45 至 77 岁）。4 例患者行全上颌骨切除术，6 例患者行扩大全上颌骨切除术。T4a 疾病患者的动脉内化疗给药次数为 2 至 4 次，T4b 疾病患者的动脉内化疗给药次数为 3 至 4 次。T4a 疾病患者的顺铂动脉内中位剂量为 360mg（范围为 250 至 400），T4b 疾病患者的顺铂动脉内中位剂量为 360mg（范围为 320 至 480）。所有患者的 5 年总生存率、5 年无病生存率和 5 年局部控制率分别为 100%、70%和 80%。6 例 T4a 患者的 5 年无病生存率和 5 年局部控制率分别为 83%和 83%，4 例 T4b 患者的 5 年无病生存率和 5 年局部控制率分别为 50%和 75%。
新辅助动脉内化疗和放疗可使 T4 SCC-MS 患者获得良好的临床结果，并可能使 T4b 病变获得手术切除。
