Japanese Journal of Clinical Oncology 31:195-202 (2001)
© 2001 Foundation for Promotion of Cancer Research
Influence of Postsurgical Residual Tumor Volume on Local Control in Radiotherapy for Maxillary Sinus Cancer
Departments of 1Radiology and 2Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba and 3Department of Radiology, University of Tsukuba, Tsukuba, Ibaraki, Japan
Background: The aim was to study the influence of postsurgical gross residual tumor volume on local control of maxillary sinus cancer treated with radiotherapy combined with debulking surgery.
Methods: Forty-three patients who underwent combined surgery and radiotherapy (50–72 Gy, median 60 Gy) for squamous cell carcinoma of the maxillary sinus were reviewed. Gross residual tumor volume (GRTV) after surgery was measured on computed tomograms obtained during the radiotherapy planning. Patients were classified according to GRTV as follows: group AA, GRTV = 0 (microscopic residual, n = 2); group A, GRTV <10 cm3 (n = 24); group B, 10–40 cm3 (n = 9); and group C, 
40 cm3 (n = 8). The relationship between local control and GRTV was analyzed using univariate and multivariate analysis.
Results: The 2-year local control rate for all patients was 62%. The differences in local control rates between groups AA, A and B were not significant (P > 0.05), but the rate was significantly lower in group C than in the other groups (69% at 2 years vs 31% at 1 year, P < 0.001). Multivariate analysis showed that GRTV (P = 0.002) and histological differentiation (poorly differentiated histology was favorable, P = 0.035) were independent prognostic factors and that intra-arterial chemotherapy and administered total dose were not. Local control in groups A and B significantly depended on the total dose of radiotherapy, with 2-year control rates of patients receiving 50 Gy (n = 6) and 60 Gy (n = 27) of 17% vs 79%, respectively (P < 0.001).
Conclusions: Our data suggest that adequate, not complete, debulking associated with a total radiotherapy dose of 60 Gy can provide satisfactory local control for patients with squamous cell carcinoma of the maxillary sinus.
+ For reprints and all correspondence: Mitsuhiko Kawashima, Department of Radiology, National Cancer Center Hospital East, 6–5–1 Kashiwanoha, Kashiwa, 277-8577 Chiba, Japan. E-mail: mkawashi@east.ncc.go.jp
Abbreviations: RT, radiotherapy; IAC, intra-arterial chemotherapy; GRTV, gross residual tumor volume; CT, computed tomography; MRI, magnetic resonance imaging; LFS, local recurrence-free survival; DSS, disease-specific survival