Complete Protocol Administration Reduces Local Recurrence and Residual Tumor in Superselective Intra-arterial Cisplatin Infusion and Concomitant Radiotherapy for Maxillary Sinus Cancer.

PURPOSE

To investigate the risk factors for local maxillary sinus squamous cell carcinoma recurrence/residual tumor after superselective intra-arterial cisplatin infusion and concomitant radiotherapy.

MATERIAL AND METHODS

The protocol of superselective intra-arterial cisplatin infusion and concomitant radiotherapy was as follows: cisplatin was administered once per week for 7 weeks, and the dose of every procedure was 100 mg/m. Radiation was administered during the same period using intensity-modulated radiation therapy, with a total dose of 70 Gy (2 Gy/35 fractions). The risk factors for local recurrence/residual tumor were retrospectively analyzed using the Cox hazard model in 31 advanced primary maxillary sinus squamous cell carcinoma cases treated with superselective intra-arterial cisplatin infusion and concomitant radiotherapy from October 2016 to 2022. The analyzed risk factors were age, sex, T- and N-factors, invasion of the pterygoid muscle, tumor heterogeneity on imaging modality, tumor signal intensity on diffusion-weighted imaging (b = 1000), tumor-brain stem signal ratio on diffusion-weighted imaging (b = 1000), therapeutic response after the fourth infusion, and complete superselective intra-arterial cisplatin infusion and concomitant radiotherapy or not. We also compared overall survival between the recurrence/residual tumor and non-recurrence groups.

RESULTS

This study included 31 patients. Non-complete superselective intra-arterial cisplatin infusion and concomitant radiotherapy was the only risk factor that showed a statistically significant difference among all the analyzed risk factors. Overall survival was favorable in the non-recurrence/residual tumor group; however, there was no statistical difference compared to the recurrence/residual tumor group.

CONCLUSIONS

Complete superselective intra-arterial cisplatin infusion and concomitant radiotherapy was the only factor that prevented local recurrence/residual tumor. Therefore, all health careers involved in superselective intra-arterial cisplatin infusion and concomitant radiotherapy should avoid interrupting whenever possible.