[Multidisciplinary treatment of cancer of the maxilla and the oral cavity].

A study was performed involving patients with cancer of the maxilla (N = 70), the oral tongue (N = 56), the lower gum (N = 30), the oral floor (N = 22), the upper gum (N = 11), the hard palate (N = 10) and the cheek (N = 11) to evaluate how far the long-term survival rate could be improved with a combination of Linac X-ray irradiation (6000 rads/30 d), chemotherapy (5-FU), and radical surgery followed by primary reconstruction. The results of the above therapy were analysed. The 5-year crude and relative survival rates for maxillary cancer were 64.2% and 72.1% respectively. For T4 squamous cell carcinoma, the crude 5-year survival rate was 63%. While the 5-year actual survival rate for all cases of tongue cancer was 80.6%, the 5-year survival rate of T2N0M0 cases in which prophylactic neck dissection was not performed routinely, was 71.4%. The 5-year survival rates for cancers of the lower gum, the oral floor, the upper gum, the hard palate and the cheek were 79.2%, 68.8%, 70.7%, 62.2% and 90.9% respectively. By combined therapy, it was possible to obtain high local control of the tumor. The most common cause of therapeutic failure was distant metastasis which was seen frequently in N1-3 cases and cases with undifferentiated or poorly differentiated carcinoma. In our present trial therapy, further combination of nonspecific immunotherapy and chemotherapy consisting chiefly of CDDP has been incorporated to control microscopic distant metastasis in these high-risk cases.