The most effective treatment for adenoid cystic carcinomas arising from minor salivary glands is surgical removal of primary lesion including the wide safety margin. However, it is well known that the salivary gland tumors have poor prognosis and high frequency of metastasis. Therefore, the multidisciplinary therapy that prevents effectively recurrence and metastasis is needed.
Two cases of adenoid cystic carcinoma of the maxillary sinus were treated according to the follwing multidisciplinary method. Case 1 (T3NOMO by JJC proposal): The patient had surgical removal of the affected maxilla and then radiation therapy. Four weeks later, adjuvant chemotherapy (Adriamycin and Cisplatin) was performed. In addition, UFT and OK-432 were administered continuously up to date from the onset of the treatment. Consequently, the patient remains be disease-free 24 months postoperation. Case 2 (T4NOMO by JJC proposeal): The patient was treated with the multidisciplinary methods such as surgical reduction of a tumor-burden, radiation therapy, intraarterial infusion of cisplatin and 5-FU into a superficial temporal artery and intradermal administration of OK-432. Thereafter, complete regression of the primary tumor was observed. However, metastasis was detected in the regional lymph nodes, which were subjected to radical neck dissection. The patient remains be disease free 8 months postoperation. These findings indicate that the multidisciplinary therapy may improve the prognosis of adenoid cystic carcinoma of the maxillary sinus.
