Abstract
1) From 1957 to 1974, 908 cases of malignant tumors of the nose and paranasal sinuses were statistically observed. The most frequent site of origin was the maxillary sinus (91.4%) and the most common histological diagnosis was carcinoma (92.5%).
2) The crude survival rates for each treatment method were caliculated in January 1975. The number of cases and the 5-year crude survival rates of the main groups were as follows:
I. Primary cases of malignant tumors (761 cases) 21.3%
A. Carcinoma (709 cases) 21.4%
B. Sarcoma (45 cases) 19.4%
II. Primary cases of maxillary sinus carcinoma (561 cases) 22.0%
A. Period 1957-1966 (282 cases) 18.4%
1. Combination of irradiation and surgery (114 cases) 31.6%
a. Stage I (43 cases) 37.2%
b. Stage II (62 cases) 29.0%
2. Irradiation alone (168 cases) 9.5%
a. Stage I (23 cases) 21.7%
b. Stage II (81 cases) 8.6%
B. Period 1967-1969 (130 cases) 30.0%
1. 5-FU intraarterial infusion (25 cases) 32.0%
2. Intraarterial infusion of other drugs (35 cases) 31.4%
3. Irradiation only without infusion (45 cases) 31.1%
C. Period 1970-1971 Linac X-ray irradiation (61 cases), 4-year crude survivai rate 14.8%
D. Period 1972-1973 5-FU infusion (80 cases), 2-year crude survival rate 51.9%
3) The following stage-grouping of maxillary sinus carcinoma was recommended for the comparison of survival rates based on the classification of tumor spread used in the TNM system.
Stage I T1-2 N0 M0
Stage II T3 N0 M0
Stage II T4 N0 M0
T1-4 N1 M0
Stage IV T1-4 N2-3 M0
T1-4 N0-3 M1
4) The best treatment method at present is 60Co γ-ray irradiation (5000 rad/25 fr/5wk.2 portals with right angle, wedge pair filter) with a continuous intraarterial infusion of 5-FU (amount of 1500-2000mg). An antrostomy is necessary and curretage is recommended during the irradiation. A maxillectomy must be performed in the event of the failure of irradiation. If the recurrence lesion is small, intracavitary irradiation may be adopted.Otherwise external irradiation is given again. A neck dissection is preferable if there is neck metastasis.
