上顎洞癌の臨床的検討

Clinical Study of Maxillary Sinus Carcinoma

　はじめに

　上顎洞癌は早期の自覚症状の発現に乏しく，頭頸部癌の中でも決して予後良好なものとはいえない。また，顔面形態の変化と機能障害が治療上問題となり，根治性を高めるとともにQOLの低下を最小限にとどめる必要がある。佐藤^1）により提唱された三者併用療法の報告以来，多施設で具体的方法に相違はあるものの三者併用療法の導入により上顎洞癌の治療成績は徐々に改善されてきた。

　今回われわれは，一次治療を施行した上顎洞癌症例の治療成績について検討したので報告する。

Forty patients with maxillary sinus carcinoma treated in our department during 10 years from 1985 to 1994 were studied.

There were 31 males and 9 females, and the aver-age age was 56 years old. The main treatment wascombined therapy consisting of intraarterial infu-sion of cisplatin, preoperative irradiation, and radi-cal operation.

The five-year survival rate was 100% in stage II, 77.3% in stage III, 28.6% in stage IV, and 62.5% overall.

Local residue or recurrence of carcinoma was found in 15 cases, and cervical metastasis in one and distant metastasis in 4 cases.

Two cases of anaplastic carcinoma and 2 cases of poorly differentiated squamous cell carcinoma died of distant metastasis.