ABSTRACT
Purpose:To study treatment and prognostic factors in 74 patients with maxillary sinus carcinoma to improve methods of treatment. Methods:From January 1985 to December 1995,74 patients with maxillary sinus carcinoma were treated in our hospital.There were 46 males and 28 females,with a median age at diagnosis of 55 years(25-76 years),the tumor histology included squamous cell carcinoma ,adenocarcinoma,undifferentiated carcinoma (found in 55,8,11 patients).Using the AJCC method of classication,T 2 4 cases,T 3 32 cases and T 4 38 cases.Twenty of 74 patients had cervical lymphadenopathy at initial presentation,fifteen of 20 patients were in ipsilateral upper neck.Total dose was 50 Gy/28 f/41 d-78 Gy/39 f/55 d.Forty three patients had radiotherapy alone,thirty one had surgical resection and radiotherapy. Kaplan Meier and Log Rank test were used for evaluating the results of the local control and survival rates in this series,the multivariate parameters were analyzed by Cox model. Results:The 5 year survival rates were 33.9% for all patients.The 5 year loss of control rates of primary site were 56.2%,the 5 year neck failurs rates were 20.0%,the 5 year metastatic rates were 19.7%.The 5 year survival rates for radiothery alone, combined therapy were 16.4% and 56.1% respectively( P =0.0003).Of the 54 patients with N 0 disease,7 had neck recurrence,of the 7 neck failure,5 were in ipsilateral upper neck.The 5 year survival rates for patients who remained N 0 were 41.9% and for those [N(+) group] with initial cervical involvement or recurred in the neck were 20%( P =0.0076). Conclusions:Primary local failure is the most cause of therapeutic failure, the neck failure is in ipsilateral upper neck in many patients whose prognosis is poor,combined treatment is beneficial in maxillary sinus carcinoma.