RESULTS OF RADIOTHERAPY IN PATIENTS WITH MAXILLARY SINUS CARCINOMA: EVALUATION OF 79 CASES

Paranasal tumors comprise of 0.2-0.5% of all cancer cases and 5% of all cases of head and neck tumors. Planning and application of radiotherapy is hampered by their localization. The aim of this study is to evaluate the out-come after radiotherapy regarding local control, prognostic factors affecting survival and morbidity of treatment. Between January 1983 and December 1996, 79 cases of maxillary sinus carcinoma without any evidence of distant metastases, received radiotherapy. Fifty-two patients (65.8%) were male and 27 (34.2%) were female. 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 tumor and 13 patients (17.2%) had lymph node metastases. In 59 patients (74.7%) radiotherapy was applied postoperatively and in 20 (25.3%) with curative intent. Median follow-up was 71 months; 5-year overall survival and local control rates were 53% and 54% respectively. Prognostic factors influencing overall survival were histologic type (p-0.02), postoperative residual tumor (p=0.002) and T stage (p=0.04). Prognostic factors influencing local control were histologic type (p=0.05) and postoperative residual tumor (p=0.005). Late radiation morbidity were cataract (11.4%), loss of vision (8.9%), trismus (5.1 %) and hearing loss (2.5%). 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 tumor, without any residue and non-epidermoid histologic type.

Keywords: maxillary sinus carcinoma, radiotherapy, prognostic factors