Squamous cell carcinoma of the maxillary sinus treated with radiation therapy and conservative surgery

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Abstract
BACKGROUND For patients with squamous cell carcinoma of the maxillary sinus, combined modality treatment is usually employed, involving radiation and en bloc radical surgery. In this study, local control was analyzed retrospectively in patients who underwent less aggressive piecemeal surgery. METHODS Of the 37 patients irradiated between 1973 and 1992, 62% were classified as having T4 lesions. Thirty‐two patients underwent surgery and radiation therapy; conventional fractionation radiation therapy was used in most cases. Thirty of these patients underwent piecemeal debulking of their tumors and simultaneous radiation therapy. RESULTS Local recurrence free survival at 5 years was 59%, and orbital exenteration was performed on only 1 patient. T classification, the number of operations, and the presence of macroscopic residual disease each had a statistically significant impact on local recurrence. For the patients with macroscopic residual disease, more than 58 gray administered in conventional fractionation appeared to be necessary to improve local control. CONCLUSIONS Combined with radiation therapy, conservative surgery with piecemeal debulking was an effective method of treatment for the patients in this study. Cancer 1998;82:104‐7. © 1998 American Cancer Society.