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Definitive Radiation Therapy Versus Postoperative Radiation Therapy for Patients With Maxillary Sinus Cancer Invading the Upper Jaw

Wang, Fang, MD*; Ren, Ming, MD*; Wu, Jianjun, MD*; Zhang, Caifeng, MS

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1234–1238
doi: 10.1097/SCS.0000000000005462
Clinical Studies

Maxillectomy following radiation therapy has the strongest local control over maxillary sinus cancer. However, in the advanced stage, complete resection is difficult with adequate margin and has the risk of functional disabilities after surgeries. The objective of the study was to determine the optimal treatment strategy for patients with maxillary sinus cancer invades the upper jaw. A total of 998 histologically confirmed maxillary sinus cancer invades the upper jaw patients were subjected to simple randomization. Patients were subjected to maxillectomy and received 150 mg/m2/wk intra-arterial cisplatin for 4 weeks followed by radiotherapy (PR group, n = 499) or received the same chemotherapy and definitive radiotherapy only (DR group, n = 499). Disease status, overall survival, progression-free survival, and treatment-emergent adverse effects were evaluated in the follow-up period of 5 years. At the end of 5 years of follow-up, both the treatments had the same overall survival (P = 0.066). Demographic characters were independent parameters for the overall survival (P ≥ 0.05 for all). Postoperative radiotherapy had a higher progression-free survival than definitive radiotherapy (P = 0.018). Maxillectomy was useful in the reduction of the evidence of local recurrence of cancer (P = 0.027). Dysphagia, palate fistula, incomprehensible voice, and trismus were reported as treatment-emergent effects in the PR group. Definitive radiation therapy is recommended in maxillary sinus cancer that invades the upper jaw (Level of Evidence: I; research registry 4571 dated November 14, 2012).

*Department of Radiotherapy

Department of General Surgery, Peace Hospital Affiliated to Changzhi Medical College, Changzhi, China.

Address correspondence and reprint requests to Caifeng Zhang, MS, Department of General Surgery, Peace Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi 046000, China; E-mail:

Received 16 December, 2018

Accepted 11 February, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.