Nayuta Tsushima1, Satoshi Kano1, Takayoshi Suzuki1, Hiroshi Idogawa1, Daisuke Yoshida1, Koichi Yasuda2, Manami Otsuka2, Hidefumi Aoyama2, Akihiro Homma3. 1. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. 2. Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan. 3. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. ak-homma@med.hokudai.ac.jp.
Abstract
PURPOSE: We have performed superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) for patients with maxillary sinus cancer. The promising treatment outcomes of this non-surgical treatment were reported in past studies. However, few clinical studies have been conducted to evaluate the outcome of salvage surgery following RADPLAT. The purpose of this study was to analyze the treatment outcomes of salvage surgery for patients with recurrent maxillary sinus cancer after RADPLAT. METHODS: We assessed 45 patients who had recurrence following RADPLAT between 1999 and 2017, and conducted a retrospective analysis. We excluded patients who did not complete RADPLAT. Patients were not considered to have completed RADPLAT if they underwent intra-arterial cisplatin less than three times or received a total radiation dose of less than 60 Gy. The primary endpoint was overall survival. The median follow-up period for surviving patients after recurrence was 5.1 years. RESULTS: Twenty-five of the 45 (56%) patients underwent salvage surgery. The 5-year overall survival rate was 68% in patients who underwent salvage surgery, while all patients who did not undergo salvage surgery died during the observation period. Fifteen of 24 (63%) patients with local recurrence underwent salvage surgery. Eight patients did not undergo salvage surgery because of unresectable disease; five of the eight patients had unresectable posterior extension. All nine patients with nodal recurrence underwent neck dissection. CONCLUSION: Treatment outcomes of salvage surgery following RADPLAT were favorable enough for it to be generally recommended. To reduce unresectable recurrence, the posterior section should be eradicated by RADPLAT.
PURPOSE: We have performed superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) for patients with maxillary sinus cancer. The promising treatment outcomes of this non-surgical treatment were reported in past studies. However, few clinical studies have been conducted to evaluate the outcome of salvage surgery following RADPLAT. The purpose of this study was to analyze the treatment outcomes of salvage surgery for patients with recurrent maxillary sinus cancer after RADPLAT. METHODS: We assessed 45 patients who had recurrence following RADPLAT between 1999 and 2017, and conducted a retrospective analysis. We excluded patients who did not complete RADPLAT. Patients were not considered to have completed RADPLAT if they underwent intra-arterial cisplatin less than three times or received a total radiation dose of less than 60 Gy. The primary endpoint was overall survival. The median follow-up period for surviving patients after recurrence was 5.1 years. RESULTS: Twenty-five of the 45 (56%) patients underwent salvage surgery. The 5-year overall survival rate was 68% in patients who underwent salvage surgery, while all patients who did not undergo salvage surgery died during the observation period. Fifteen of 24 (63%) patients with local recurrence underwent salvage surgery. Eight patients did not undergo salvage surgery because of unresectable disease; five of the eight patients had unresectable posterior extension. All nine patients with nodal recurrence underwent neck dissection. CONCLUSION: Treatment outcomes of salvage surgery following RADPLAT were favorable enough for it to be generally recommended. To reduce unresectable recurrence, the posterior section should be eradicated by RADPLAT.
Authors: JeeHong Kim; Seungwon Kim; William G Albergotti; Phillip A Choi; Daniel James Kaplan; Shira Abberbock; Jonas T Johnson; Neil Gildener-Leapman Journal: JAMA Otolaryngol Head Neck Surg Date: 2015-12 Impact factor: 6.223
Authors: Bradford S Hoppe; Carl J Nelson; Daniel R Gomez; Lauren D Stegman; Abraham J Wu; Suzanne L Wolden; David G Pfister; Michael J Zelefsky; Jatin P Shah; Dennis H Kraus; Nancy Y Lee Journal: Int J Radiat Oncol Biol Phys Date: 2008-04-18 Impact factor: 7.038
Authors: James S Brown; Fazilet Bekiroglu; Richard J Shaw; Julia A Woolgar; Asterios Triantafyllou; Simon N Rogers Journal: Br J Oral Maxillofac Surg Date: 2012-05-11 Impact factor: 1.651
Authors: A Homma; T Sakashita; D Yoshida; R Onimaru; K Tsuchiya; F Suzuki; K Yasuda; H Hatakeyama; J Furusawa; T Mizumachi; S Kano; N Inamura; S Taki; H Shirato; S Fukuda Journal: Br J Cancer Date: 2013-11-05 Impact factor: 7.640