Radiotherapy in maxillary sinus carcinomas: Evaluation of 79 cases

Abstract

Purpose: The aim of this study is to evaluate the outcome of patients with maxillary sinus carcinoma after radiotherapy regarding local control, prognostic factors and morbidity of treatment. Materials and methods: Between January 1983 and December 1996, 79 cases of maxillary sinus carcinoma without any evidence of distant metastases, were treated with radiotherapy. Results: Fifty-two patients (65.8%) were male and 27 (34.2%) were female. The median age was 57. Histologically 62% were epidermoid carcinoma, 32.9% were non-epidermoid carcinoma and 5.1% were unclassified. Sixteen patients (20.5%) had T2, 25 (29.8%) had T3 and 38 (49.7%) had T4 tumour while 13 patients (16.5%) had lymph node metastases. Fifty-nine patients (74.4%) underwent surgical resection followed by postoperative radiotherapy and 20 patients (25.3%) received radiotherapy alone. The median follow-up was 71 months; 5-year overall survival and local control rates were 53% and 54% respectively. Prognostic factors influencing the overall survival were histologic type (epidermoid carcinoma, p=0.02), advanced T stage (p=0.04), postoperative residual tumour (p=0.002) and lymph node involvement (p=0.01) whereas the factors influencing local control were histologic type (p=0.05) and postoperative residual tumour (p=0.005). Late radiation morbidity were cataract (11.4%), loss of vision (8.9%), trismus (5.1%) and hearing loss (2.5%). Conclusion: In maxillary sinus carcinomas high rates of local control can be achieved with surgery and radiotherapy. Postoperative radiotherapy can have a positive impact on local control and overall survival especially in patients with early stage tumour of non-epidermoid histology and without residual disease after surgery.