抄録
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.
