Definitive Radiation Therapy Versus Postoperative Radiation Therapy for Patients With Maxillary Sinus Cancer Invading the Upper Jaw

Abstract

Maxillectomy following radiation therapy has the strongest local control over maxillary sinus cancer. However, in the advanced stage, complete resection is difficult with adequate margin and has the risk of functional disabilities after surgeries. The objective of the study was to determine the optimal treatment strategy for patients with maxillary sinus cancer invades the upper jaw. A total of 998 histologically confirmed maxillary sinus cancer invades the upper jaw patients were subjected to simple randomization. Patients were subjected to maxillectomy and received 150 mg/m2/wk intra-arterial cisplatin for 4 weeks followed by radiotherapy (PR group, n = 499) or received the same chemotherapy and definitive radiotherapy only (DR group, n = 499). Disease status, overall survival, progression-free survival, and treatment-emergent adverse effects were evaluated in the follow-up period of 5 years. At the end of 5 years of follow-up, both the treatments had the same overall survival (P = 0.066). Demographic characters were independent parameters for the overall survival (P ≥ 0.05 for all). Postoperative radiotherapy had a higher progression-free survival than definitive radiotherapy (P = 0.018). Maxillectomy was useful in the reduction of the evidence of local recurrence of cancer (P = 0.027). Dysphagia, palate fistula, incomprehensible voice, and trismus were reported as treatment-emergent effects in the PR group. Definitive radiation therapy is recommended in maxillary sinus cancer that invades the upper jaw (Level of Evidence: I; research registry 4571 dated November 14, 2012).

Retrospective analysis of 98 cases of maxillary sinus squamous cell carcinoma and therapeutic exploration

“…1b). Mountains of evidence revealed that comprehensive treatment involving surgery may have a better curative effect than surgery alone [1,[9][10][11]. Similarly, in the present study, 98 patients with MSSCC were divided into four groups: SUR (n = 8), SUR+CT/RT (n = 38), CT/RT+SUR (n = 19), and NON-SUR (n = 33).…”

“…Chemoradiotherapy was confirmed to play an important part in the treatment of MSSCC, especially for tumors with positive margins or high-risk features [20,21]. Mountains of evidence have shown that postoperative chemotherapy and/or radiotherapy are associated with better survival outcomes of MSSCC patients compared with surgery alone [9,16,21]. However, studies that focused on comparisons between upfront surgery and neoadjuvant chemotherapy and/ or radiotherapy followed by surgery in patients with MSSCC showed different results [19].…”

“…It is generally accepted that surgery-based treatment remains the first-line therapeutic strategy for MSSCC [5][6][7][8], according to the National Comprehensive Cancer Network (NCCN) recommendation [8]. And comprehensive treatment involving surgery was observed to have a better curative effect than surgery alone [9][10][11]. However, controversial issues still exist that whether neoadjuvant chemotherapy and/or radiotherapy benefit patient prognosis better, comparing with post-operation adjuvant chemotherapy and/or radiation.…”

Sinonasal adenocarcinoma: a case series

“…Clinically, the practitioner should examine for any facial asymmetry or swelling, followed by anterior rhinoscopy to inspect for visible nasal masses, otoscopy to detect dull tympanic membrane, palpation over the neck to reveal neck mass, and completing the examination with a neurological examination to inspect for cranial nerve palsy, I to VI in particular (4) . Maxillary sinus malignancy tends to be associated with oro-nasal, oro-antral fistula, or loose teeth, therefore the involvement of the alveolar process of the maxilla should be ruled out (7) . Nasoendoscopy allows for detailed examination of the nasal cavity anatomy, particularly in cases where the tumour does not completely obstruct the nasal cavity, identification or suggestion of the tumour possible origin, local extension, and anatomy assessment as part of preoperative planning (4) .…”

Treatment Outcomes of Maxillary Sinus Squamous Cell Carcinoma at a Dedicated Cancer Institute: A Retrospective Study

“…In our study stage, margins status and treatment modalities were independent factors not significantly associated with treatment failure. However, in literature, evidence shows that postoperative adjuvant radiotherapy or chemotherapy is associated with better survival outcomes in maxillary sinus malignant tumors than surgery alone [ 32 , 36 , 39 ].…”