晚期上颌窦癌综合治疗远期疗效

LONG-TERM EFFECT OF COMBINED THERAPY FOR ADVANCED CANCER OF THE MAXILLARY SINUS

1975～1987年对70例晚期上颌窦癌采用术前放疗、术后放疗或插管化疗加放疗的综合治疗。5年生存率:14例术前放疗为63.6％,41例术后放疗为48.6％;52例Ⅲ期为62.9％,16例Ⅳ期为21.4％。术前或术后放疗最佳剂量为D_T55～65Gy,5年生存率70.8％。本组对14例患者采用3种方法插管化疗加放疗,无法评价疗效,本组治疗失败的主要原因是局部未控或复发,30例死亡中,局部复发占83.3％,肝、肺转移各占13.3％。

From 1975 to 1987, 70 patients with advanced maxillary sinus carcinoma were treated by combined therapy (surgery plus preoperative radiotherapy 14 cases and postoperative radiotherapy 41 cases or infusion chemotherapy plus radiotherapy 14 cases). There were 71% squamous carcinoma and 20% adenocarcinoma. 74- 2% had Stage Ⅲ and 23%, Stage Ⅳ lesions. Preoperative radio-theapy plus surgery was better than surgery plus postoperative radiotherapy, with respective 5-year survival rates of 63. 6% and 48. 6%. The 5-year survival rates of Ⅲ and Ⅳ stages were 63% and 21% respectively. Those of squamous carcinoma, adenocarcinoma and cystic adeno-cardinoma were 55%, 33% and 50%. The optimum dose was 55-65 Gy, giving a 5-year survival rate of 70. 8%. The cause of failure was local uncontrol or recurrence. Twenty-five patients have died of local recurrence , 2 of metastasis and 1 of non-cancer cause. The authors believe that pre-opeative radiotherapy plus surgery is best and infusion therapy plus radiotherapy is doubtful.