Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_39_2524 - A Retrospective Study of 3D-CRT/IMRT and Concomitant Intra-arterial Chemotherapy for Maxillary Sinus Carcinoma

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

A Retrospective Study of 3D-CRT/IMRT and Concomitant Intra-arterial Chemotherapy for Maxillary Sinus Carcinoma
J. Hashiba1, R. Harada1, M. Watanabe Nemoto1, G. Togasaki1, M. Kurokawa1, H. Kobayashi1, T. Horikoshi1, T. Hanazawa2, Y. Okamoto2, and T. Uno1; 1Department of Radiology, Chiba University Hospital, Chiba, Japan, 2Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan

Purpose/Objective(s): Maxillary sinus carcinoma is treated with multidisciplinary approach, and a good candidate for radiation with concomitant intra-arterial chemotherapy at an advanced stage because of its close vicinity to the critical structures. However, due to its rarity of the disease, there have been a limited number of reports relating to the treatment outcomes. The purpose of the study was to evaluate the effectiveness of 3D-CRT/IMRT and concurrent intra-arterial chemotherapy for maxillary sinus carcinoma.

Materials/Methods: Fifty-eight patients with maxillary sinus carcinoma treated between January 2003 and December 2015 were retrospectively reviewed. Forty-two patients were diagnosed as Stage IVa/IVb. All the patients had squamous cell carcinoma and received 3D-CRT with (2 patients) or without (56 patients) additional IMRT. Concurrent intra-arterial cisplatin-based chemotherapy was performed. Overall survival (OS) and local control rate (LCR) were calculated using the Kaplan-Meier method to estimate the efficacy of treatment. Acute and late toxicities were graded according to CTCAE version 4.0.

Results: The median follow-up period was 36.4 months (range, 2.2-162.5 months). The median total dose was 60 Gy (range, 40-70 Gy) in conventional fractionation (2.0 Gy). The median cisplatin dose was 219 mg/m2 (range, 45-802 mg/m2). Of 58 patients, 33 were assessed as complete response (CR) at completion of chemoradiation, whereas 22 as partial response, 2 as stable disease, and 1 as progressive disease. Seventeen patients in non-CR group received further surgical resection, of which 12 patients achieved local control and long-term survivals. 3- and 5-year OSs were 71% and 63%, respectively. LCRs at 3 and 5 years were 72% and 68%, respectively. The first site of failure was local in 15, regional in 7 and distant in 12 patients. Two treatment-related deaths were reported. Acute grade 3 mucositis was seen in 4 patients (14.3%), and grade 3 dermatitis in 1 patient (3.6%). Eye disorders were the most common late toxicity, of which 2 patients (7.1%) developed grade 4.

Conclusion: Although many maxillary sinus cancers were diagnosed at an advanced stage, the study results indicated that outstanding outcomes can be achieved by concurrent intra-arterial chemoradiation with appropriate surgical salvage.

Author Disclosure: J. Hashiba: None. R. Harada: None. M. Watanabe Nemoto: None. G. Togasaki: None. H. Kobayashi: None. T. Uno: None.

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