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BACK GROUND: A common pedicled facial technique in head and neck reconstruction is the TMF It can be utilised to replace missing tissues in a variety of conditions, including oral deformities of the hard and soft palate. AIM: Aim of the study was to document the utility and outcomes with the reconstruction of the palate using TM flaps following Maxillectomy For maxillary sinus malignancies. METHODOLOGY: The study included 24 patients who were operated on for cancer maxilla and eligible for maxillectomy and reconstruction of the Palate using temporalis flap. Follow-up was planned for at least 12 months postoperative. Postoperative physical and speech therapy are initiated to help improve speech and swallow outcomes and to prevent trismus. RESULTS: The current study included 24 cases with Maxillary sinus cancer with a mean age of 42.34 ± 4.67. The mean operative time was 5.4 ± 1.22 h with no reported intraoperative bleeding or injury of important structures. No cases of facial palsy or trismus were reported while partial flap loss was reported in one case where oronasal fistula was evident. The donor site complications were minimal where seroma occurred in two patients and alopecia, wound infection and dehiscence were reported in one case each. The donor site depression was evident in 25 % of cases. CONCLUSION: TMF is an excellent option for the reconstruction of many craniofacial defects, it is easy to be harvested with good blood supply with minimal postoperative complications.

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BACKGROUND/AIM: Dosimetric parameters in volumetric modulated arc therapy (VMAT), non-coplanar VMAT (NC-VMAT), and automated NC-VMAT (HyperArc, HA) were compared for patients with maxillary sinus carcinoma (MSC). PATIENTS AND METHODS: Twenty HA plans were generated to deliver 70.4, 64, and 46 Gy for planning target volumes with high (PTV1), intermediate (PTV2), and low risk (PTV3), respectively. The VMAT and NC-VMAT plans were retrospectively generated using the same optimized parameters as those used in the HA plans. RESULTS: For PTV1, the three treatment plans provided comparable target coverages. For PTV2, the D95%, D99%, and Dmin in the HA plans (64.7±1.2, 62.7±2.1 and 54.6±6.2 Gy, respectively) were significantly higher (p<0.05) than those in the VMAT plans (64.3±1.7, 61.9±2.4 and 52.9±6.4 Gy, respectively). The NC-VMAT and HA plans provided significantly higher (p<0.05) dosimetric parameters for PTV3 than those in the VMAT plans, and D99% in the HA was significantly higher than that in the NC-VMAT plans (52.5±3.0 vs. 51.8±2.7 Gy, p<0.05). The doses to the brain and brainstem were lowest in the HA plans (p<0.05). Moreover, dosimetric parameters of the contralateral organs (lens, optic nerve, retina, and parotid) were lower in the HA plans than in the VMAT and NC-VMAT plans. CONCLUSION: The HA plans provided the best target coverage and OAR sparing compared with VMAT and NC-VMAT plans for patients with MSC.

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Carcinoma , Radioterapia de Intensidad Modulada , Humanos , Seno Maxilar , Dosificación Radioterapéutica , Órganos en Riesgo , Estudios Retrospectivos , Planificación de la Radioterapia Asistida por Computador

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OBJECTIVES: Herein, we purposed to establish and verify a competing risk nomogram for estimating the risk of cancer-specific death (CSD) in Maxillary Sinus Carcinoma (MSC) patients. METHODS: The data of individuals with MSC used in this study was abstracted from the (SEER) Surveillance, Epidemiology, and End Results data resource as well as from the First Affiliated Hospital of Nanchang University (China). The risk predictors linked to CSD were identified using the CIF (cumulative incidence function) along with the Fine-Gray proportional hazards model on the basis of univariate analysis coupled with multivariate analysis implemented in the R-software. After that, a nomogram was created and verified to estimate the three- and five-year CSD probability. RESULTS: Overall, 478 individuals with MSC were enrolled from the SEER data resource, with a 3- and 5-year cumulative incidence of CSD after diagnosis of 42.1% and 44.3%, respectively. The Fine-Gray analysis illustrated that age, histological type, N stage, grade, surgery, and T stage were independent predictors linked to CSD in the SEER-training data set (n = 343). These variables were incorporated in the prediction nomogram. The nomogram was well calibrated and it demonstrated a remarkable estimation accuracy in the internal validation data set (n = 135) abstracted from the SEER data resource and the external validation data set (n = 200). The nomograms were well-calibrated and had a good discriminative ability with concordance indexes (c-indexes) of 0.810, 0.761, and 0.755 for the 3- and 5-year prognosis prediction of MSC-specific mortality in the training cohort, internal validation, and external validation cohort, respectively. CONCLUSIONS: The competing risk nomogram constructed herein proved to be an optimal assistant tool for estimating CSD in individuals with MSC.

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PURPOSE: Anatomical changes, such as shrinkage and aeration, can affect dose distribution in proton therapy (PT) for maxillary sinus carcinoma (MSC). These changes can affect the dose to the target and organs at risk (OARs); however, when these changes occur during PT is unclear. This study aimed to investigate the dosimetric impact of anatomical changes during PT. MATERIALS AND METHODS: Fifteen patients with MSC were enrolled in this study. Initial PT plans were generated based on initial computed tomography (CT) images. Several repeat CT images were obtained to confirm anatomical changes during PT. Evaluation PT plans were generated by copying initial PT plans to repeat CT images. The dose differences of the target and OARs were evaluated by comparing both the plans. RESULTS: At 3-4 weeks after the initiation of PT, the target volume reduced by approximately 10% as compared with the initial volume. Consequently, the target volumes gradually varied until the end of treatment. The value of V95 (volume that received 95% of the prescription dose) in the clinical target volume of the evaluation PT plan was similar to that of the initial PT plan. However, the dose to OARs, such as the contralateral optic nerve, contralateral eyeball, brainstem, and optic chiasm, increased significantly from the middle to the later phases of the treatment course. In contrast, there was a slight dose difference in the ipsilateral optic apparatus. CONCLUSION: The trend analysis in this study showed that anatomical changes appeared 3-4 weeks after the start of PT, and the dose to the OARs tended to increase. Therefore, it is recommended to check the status of tumor 3-4 weeks after the start of treatment to avoid the deterioration of dose distribution due to these changes.

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Carcinoma , Terapia de Protones , Humanos , Seno Maxilar/diagnóstico por imagen , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador

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The purpose of this study was to describe the results of definitive radiotherapy (RT) with concurrent chemotherapy for maxillary sinus carcinomas (MSCs) with neck lymph node metastasis to clarify its limitation. Local control (LC), progression-free survival (PFS) and overall survival (OS) rates were calculated using the Kaplan-Meier method and were compared between subgroups using the log rank test. Toxicity was classified using common terminology criteria of adverse events version 5.0. Eighteen patients with inoperable MSC with neck lymph node metastasis including 12 men and 6 women with a median age of 67 years were analyzed. The histologic diagnoses were as follows: 16 patients had squamous cell carcinomas and 2 had other histology. Four patients had stage T3 MSC, 6 had T4a and 8 had T4b. Among 18 patients, 7 received concurrent systemic chemotherapy and 11 received selective arterial chemo-infusion. The median follow-up period was 17 months. The 2-year LC, PFS and OS rates for the entire cohort were 34, 31 and 46%, respectively. No significant differences were observed for LC, PFS and OS rates between systemic chemotherapy and selective arterial chemo-infusion cohorts. Grade 3 or higher acute toxicity, including both non-hematological and hematological, was observed in nine patients (50%), while no grade 3 or higher late toxicity was observed. In conclusion, we described the results of definitive RT for MSCs with neck lymph node metastasis. Local recurrence of primary tumor was a frequent pattern of failure and it should be addressed in future study.

Asunto(s)

Quimioradioterapia , Metástasis Linfática/terapia , Neoplasias Maxilares/terapia , Seno Maxilar/patología , Cuello/patología , Adulto , Anciano , Anciano de 80 o más Años , Quimioradioterapia/efectos adversos , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento

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This article reviews the most common locations and natural history of sinonasal carcinomas. It also reviews surgical indications and current evidence regarding adjuvant and neoadjuvant therapies. In the past, orbital clearance was generally done for ethmoid and maxillary cancers, even without a marked neoplastic infiltration; however, such indications have changed in the recent years due to advances in our understanding of the disease, as well as new chemotherapeutic and radiotherapy protocols. Surgical resection of tumors close to the orbit exhibits the challenging task of balancing treatment goals and patient's desires.

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OBJECTIVE: Since 2010, we have mainly performed surgical treatment following radiotherapy and concomitant intraarterial cisplatin (RADPLAT) for locally advanced maxillary sinus cancer (MSC). The present study investigated treatment results and pathological evaluations following RADPLAT for MSC. METHODS: Pathological response to RADPLAT was evaluated using surgical specimens. Pathological response was graded in accordance with the classification method that Shimosato reported in 1964, as grade V (no tumor cells remain in any of section), grade IV, III, II, I, and 0. Five-year overall and disease-specific survival rates were estimated using Kaplan-Meier methods. Univariate analyses of correlations between recurrence of MSC and other clinicopathological parameters were evaluated using the chi-square or Fisher's exact tests. RESULT: 19 patients were enrolled in this study, 5 patients showed T3 disease and 14 had T4 disease. One patient demonstrated local recurrence and 3 patients experienced distant metastasis. The 5-year overall survival rate was 67.1% (T3, 50.0%; T4, 69.6%), and the 5-year disease-specific survival rate was 81.9% (T3, 100%; T4, 76.0%). Histological response was categorized as grade V in 9 cases. No significant risk factors for residual cancer were identified. CONCLUSION: Our study suggested that RADPLAT not only has a low risk of side effects, but also could represent an effective procedure for locally advanced MSC by pathological evaluation. Increasing the therapeutic intensity of RADPLAT might provide an effective modality to avoid highly invasive surgery.

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Antineoplásicos/administración & dosificación , Quimioradioterapia , Cisplatino/administración & dosificación , Neoplasias del Seno Maxilar/terapia , Anciano , Carcinoma Adenoescamoso/patología , Carcinoma Adenoescamoso/terapia , Quimioradioterapia/efectos adversos , Femenino , Humanos , Infusiones Intraarteriales , Estimación de Kaplan-Meier , Masculino , Neoplasias del Seno Maxilar/mortalidad , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Sarcoma/mortalidad , Sarcoma/patología , Sarcoma/terapia , Tasa de Supervivencia , Tiosulfatos/administración & dosificación

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The surgical treatment of maxillary tumours often consists of an open subtotal or total maxillectomy with a subsequent significant defect. Reconstruction is, therefore, a major challenge for head and neck surgeons. Along with 3D printing development, titanium pre-bent implants have been created for orbital wall and floor reconstruction. The aim of this study was to evaluate the post-operative tolerance of these implants in patients who had undergone this procedure in our department. Implant tolerance was the primary endpoint, evaluated by whether or not surgery was required for infection or extrusion 6 months after the procedure. The secondary endpoints were satisfactory functional and aesthetic characteristics of the reconstruction as well as the quality of life. Eleven patients underwent a maxillectomy with orbital floor resection for tumours and reconstruction using the titanium PorousiTi® (Materialise®, Leuven, Belgium) implant beginning in 2013 in Lariboisière Hospital, Paris. The mean follow-up time was 17 months (range, 6-34). During the follow-up period, two patients (n = 2/11; 18.2%) were operated again for implant extrusion and exposure through the skin 1 month later or during their radiotherapy course. During the follow-up period, no post-operative infection occurred in any of the patients. In our experience, the implant was well-tolerated with few post-operative complications and satisfactory aesthetic and functional results.

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Maxilar/cirugía , Neoplasias Maxilares/cirugía , Órbita/cirugía , Procedimientos de Cirugía Plástica/métodos , Impresión Tridimensional , Prótesis e Implantes , Titanio , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis/métodos , Estudios Retrospectivos , Adulto Joven

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This case report illustrates a treatment effect of image-guided high-dose-rate (HDR) interstitial brachytherapy for refractory recurrence of maxillary sinus carcinoma. A 61-year-old male was previously admitted to another hospital and received surgery because of left maxillary sinus squamous cell carcinoma (SCC) 6 years ago. Tumor regrowth was noted 2 years after the initial radical surgery. The patient accepted local excision again for the recurrence, followed by external beam radiotherapy. Despite salvage treatment with surgery and external irradiation, the lesion expanded as 4.8 × 4.4 × 4.0 cm3. Because the patient refused palliative resection, we recommended technique of image-guided HDR interstitial brachytherapy. The total doses of 42 Gy in 12 fractions were delivered to the whole recurrent tumor. Removal of the recurrent tumor was securely achieved by HDR interstitial brachytherapy, guided with ultrasound. The refractory tumor in the patient healed uneventfully after HDR interstitial brachytherapy without recurrence during 8 months of follow-up. This case is remarkable because the patient experienced complete remission by a safe and practicable method with image-guided HDR interstitial brachytherapy.

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Advances in the diagnosis and treatment of patients with maxillary sinus carcinoma have improved patient prognosis. This study investigated changes in demographic and clinical characteristics, treatment methods, and outcomes of patients with maxillary sinus carcinomas during three different 10-year periods spanning 60 years at our university hospital. Of the 233 patients with maxillary sinus carcinomas managed at Nagoya University Hospital, 135 were treated between 1951 and 1960 (first period), 35 between 1981 and 1990 (second period), and 63 between 2003 and 2012 (third period). Patient age, sex, TN classifications, treatment methods, and survival rates were compared among patients treated during these time periods. Of the 135, 35, and 63 patients with maxillary sinus carcinomas treated during these time periods, 86 (63.7%), 21 (51.4%), and 48 (76.2%), respectively, were men; 14 (10.4%), six (17.1%), and 14 (22.2%), respectively, were aged ≥70 years; and 135 (100%), 28 (80.0%), and 43 (68.3%), respectively, were treated surgically. The 5-year overall survival rates in patients treated during the first, second, and third periods were 29.7%, 44.3%, and 57.5%, respectively. These findings indicated that advances in the diagnosis and treatment of patients with maxillary sinus carcinoma, including computed tomography and craniofacial resection, have contributed to improvements in patient survival rates.

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Neoplasias del Seno Maxilar/diagnóstico , Neoplasias del Seno Maxilar/cirugía , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Neoplasias del Seno Maxilar/mortalidad , Persona de Mediana Edad , Tasa de Supervivencia , Adulto Joven

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PURPOSE: To analyze the outcomes following re-irradiation for local recurrence of rare head and neck tumors. MATERIAL AND METHODS: We retrospectively analyzed 11 patients who had received intensity-modulated radiation therapy (IMRT) for recurrent tumors in the head and neck except for laryngopharynx. RESULTS: Primary tumor sites included the maxillary sinus, nasal cavity, and external ear canal in six, three, and two patients, respectively. The median follow-up times were 13 (range, 3-54) months. The median survival time was 17 months with 1- and 2-year survival rates of 63.64 and 39.77%, respectively. Among 11 patients, five experienced local failure in the follow-up period. The 1- and 2-year local control rates were 58 and 47%, respectively. Patients who had received a radiation dose of ≥3 Gy per fraction showed significantly better local control than those receiving less (p = .0419). One patient experienced Grade 3 facial pain as acute toxicity. Late toxicities included radiographic findings of partial central nervous system necrosis in three patients and Grade 3 osteonecrosis and Grade 3 facial nerve disorder in one patient. CONCLUSIONS: Re-irradiation of rare head and neck tumors using IMRT for loco-regional recurrence may be an acceptable treatment option.

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Carcinoma/radioterapia , Estesioneuroblastoma Olfatorio/radioterapia , Neoplasias de Cabeza y Cuello/radioterapia , Anciano , Anciano de 80 o más Años , Carcinoma/mortalidad , Femenino , Neoplasias de Cabeza y Cuello/mortalidad , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Radioterapia de Intensidad Modulada , Estudios Retrospectivos

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PURPOSE: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. MATERIALS AND METHODS: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. RESULTS: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/ or distant failure showed significantly worse prognosis. CONCLUSION: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.

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PURPOSE: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. MATERIALS AND METHODS: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. RESULTS: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT (‘ENT (+) group’) and 84 (68%) did not (‘ENT (−) group’). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (−) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. CONCLUSION: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.

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Humanos , Supervivencia sin Enfermedad , Estudios de Seguimiento , Cuello , Pronóstico , Resultado del Tratamiento

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BACKGROUND: Maxillary sinus carcinoma is an uncommon malignancy. Most reports on prognosis of this disease are from single institutions and include few patients. We used data from the United States National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program to construct models and nomograms for predicting outcomes of patients with maxillary sinus carcinomas. METHODS: We used records from 668 patients with primary maxillary sinus carcinomas reported to the SEER program from 2004 to 2013 to build nomograms based on stratified multivariable Cox proportional hazard models for predicting 5-year overall survival (OS) and cause-specific survival (CSS). Model building was internally validated with the bootstrap approach. RESULTS: Five-year survival was 39.7% (95% confidence interval [CI], 35.5% to 44.5%) and 46.8% (42.3% to 51.8%) for OS and CSS, respectively. The final Cox model included the variables of age at diagnosis, tumor size, histologic type, TNM stage, and surgery. Radiotherapy was a stratification factor in the models. The models demonstrated good accuracy for predicting survival with a bootstrap-corrected Somers Dxy of 0.44 for both OS and CSS models. Calibration curves indicated acceptable model calibration. CONCLUSION: We developed tools for predicting prognosis that incorporate TNM stage and other readily available variables for patients with maxillary sinus carcinomas. The model performance was validated as good. These models can help clinicians to offer improved patient counseling in terms of clinical outcomes and make optimal treatment plans.

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Neoplasias del Seno Maxilar/diagnóstico , Seno Maxilar/cirugía , Modelos de Riesgos Proporcionales , Factores de Edad , Anciano , Toma de Decisiones Clínicas , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/mortalidad , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Riesgo , Análisis de Supervivencia , Resultado del Tratamiento

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CLINICAL CASE: A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: haemorrhages, exudates, macular oedema, and peripheral retinal ischaemia. A poor outcome was achieved despite laser treatment and intravitreal injections of bevacizumab, resulting in evisceration of the affected eye. DISCUSSION: Radiation retinopathy must be considered in any loss of vision after head and neck irradiation. Ophthalmological long-term follow-up of these patients is essential for an early diagnosis.

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Carcinoma/radioterapia , Neoplasias del Seno Maxilar/radioterapia , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Retina/lesiones , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Evisceración del Ojo , Humanos , Isquemia/etiología , Edema Macular/etiología , Masculino , Persona de Mediana Edad , Hemorragia Retiniana/etiología

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The purpose of our study was to assess the feasibility of radiotherapy (RT) for locally advanced paranasal sinus carcinomas in late elderly patients (aged ≥75 years) from a single institution in Japan. From 2000 to 2015, we retrospectively analyzed 14 patients (11 maxillary and 3 ethmoid sinus carcinoma patients) who underwent RT for pathologically confirmed paranasal sinus carcinomas. RT was performed without unexpected cessations. Two patients, however, developed Grade 3 mucositis. The median follow-up duration was 13 months (range 2-54 months). The 1- and 2-year overall survival (OS) rates were 81.8 and 54.5 %, respectively. The local response rate after the initial treatment was 85.7 %. The 1- and 2-year progression-free survival (PFS) rates were 46.2 and 24.8 %, respectively. Univariate analysis of different clinicopathological parameters was conducted to identify associations with OS and PFS. We demonstrated that intensity modulated radiation therapy (IMRT) of >60 Gy with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy led to improved OS and PFS rates, although no statistical significance was observed. Moreover, none of the squamous cell carcinoma (SCC) patients who received 33 fractions of 66 Gy in IMRT died during the median follow-up period of 13 months (range 12-25 months). In conclusion, RT with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy can be considered an effective, well-tolerated, and feasible treatment option for late elderly patients with paranasal sinus carcinomas. In addition, >60 Gy of RT in IMRT led to improved survival outcomes in elderly paranasal sinus carcinoma patients.

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Carcinoma/radioterapia , Neoplasias de los Senos Paranasales/radioterapia , Radioterapia de Intensidad Modulada , Anciano , Anciano de 80 o más Años , Antineoplásicos/uso terapéutico , Carcinoma/tratamiento farmacológico , Carcinoma/mortalidad , Carcinoma/patología , Quimioradioterapia , Cisplatino/uso terapéutico , Supervivencia sin Enfermedad , Estudios de Factibilidad , Femenino , Humanos , Japón , Masculino , Neoplasias de los Senos Paranasales/tratamiento farmacológico , Neoplasias de los Senos Paranasales/mortalidad , Neoplasias de los Senos Paranasales/patología , Estudios Retrospectivos

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INTRODUCTION: C-X-C chemokine receptor type 7 (CXCR7) has recently been characterised as a novel receptor for the C-X-C motif chemokine 12 (CXCL12)/stromal cell-derived factor 1-alpha. CXCR7 has been thought to play an important role in the pathogenesis of chronic rhinosinusitis, angiogenesis and tumour metastasis. The present study aimed to examine the expression of CXCR7 in tissue samples of laryngeal cancer and maxillary sinus carcinoma to determine its role in the development of otorhinolaryngologic neoplasms. METHODS: Samples of otorhinolaryngologic neoplasms were obtained from 17 patients with either nasal polyps (n = 7), laryngeal cancer (n = 5) or maxillary sinus carcinoma (n = 5), and who underwent surgical resection at West China Hospital of Sichuan University. Total RNA was isolated and CXCR7 mRNA expression was examined and quantified by relative real-time reverse transcription polymerase chain reaction. A one-way analysis of variance was performed using SPSS Statistics version 11.0 (SPSS Inc, Chicago, IL, USA) to compare the CXCR7 mRNA levels among the three groups of patients. RESULTS: All samples tested positive for CXCR7 mRNA. The quantitative results showed that the CXCR7 mRNA levels were highest in laryngeal cancer and lowest in maxillary sinus carcinoma neoplasms, although there was no significant difference among the three samples. CONCLUSION: CXCL12 and its receptor CXCR7 may contribute to eosinophilic inflammation in patients with chronic sinusitis and nasal polyps. Our results also suggest that CXCR7 may play a role in the progression, metastasis and angiogenesis of otorhinolaryngologic tumours.

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Carcinoma de Células Escamosas/genética , Regulación Neoplásica de la Expresión Génica , Neoplasias de Oído, Nariz y Garganta/genética , ARN Neoplásico/genética , Receptores CXCR/genética , Anciano , Biomarcadores de Tumor/biosíntesis , Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de Oído, Nariz y Garganta/metabolismo , Neoplasias de Oído, Nariz y Garganta/patología , Reacción en Cadena en Tiempo Real de la Polimerasa , Receptores CXCR/biosíntesis

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OBJECTIVE: This study aimed to evaluate the efficacy and toxicity of proton beam therapy combined with cisplatin intra-arterial infusion via a superficial temporal artery as treatment for maxillary sinus carcinoma. METHODS: Twenty-six patients with confirmed maxillary sinus carcinoma were enrolled in this study from May 2009 to April 2011. Patients underwent proton beam therapy and intra-arterial infusion chemotherapy with cisplatin. RESULTS: The median total dose was 70.4 GyE per 32 fractions, and the median dose of cisplatin was 300 mg/body for six cycles of intra-arterial infusion. The 3-year overall survival rate was 58% for all patients (n = 26), 58% for patients with stage T4 disease (n = 12), 57% for patients with

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Antineoplásicos/administración & dosificación , Carcinoma de Células Escamosas/radioterapia , Quimioradioterapia , Cisplatino/administración & dosificación , Seno Maxilar , Neoplasias de los Senos Paranasales/radioterapia , Terapia de Protones , Arterias Temporales , Anciano , Carcinoma de Células Escamosas/patología , Quimioradioterapia/métodos , Esquema de Medicación , Femenino , Humanos , Infusiones Intraarteriales/métodos , Masculino , Seno Maxilar/patología , Persona de Mediana Edad , Neoplasias de los Senos Paranasales/patología , Análisis de Supervivencia , Resultado del Tratamiento

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<p><b>INTRODUCTION</b>C-X-C chemokine receptor type 7 (CXCR7) has recently been characterised as a novel receptor for the C-X-C motif chemokine 12 (CXCL12)/stromal cell-derived factor 1-alpha. CXCR7 has been thought to play an important role in the pathogenesis of chronic rhinosinusitis, angiogenesis and tumour metastasis. The present study aimed to examine the expression of CXCR7 in tissue samples of laryngeal cancer and maxillary sinus carcinoma to determine its role in the development of otorhinolaryngologic neoplasms.</p><p><b>METHODS</b>Samples of otorhinolaryngologic neoplasms were obtained from 17 patients with either nasal polyps (n = 7), laryngeal cancer (n = 5) or maxillary sinus carcinoma (n = 5), and who underwent surgical resection at West China Hospital of Sichuan University. Total RNA was isolated and CXCR7 mRNA expression was examined and quantified by relative real-time reverse transcription polymerase chain reaction. A one-way analysis of variance was performed using SPSS Statistics version 11.0 (SPSS Inc, Chicago, IL, USA) to compare the CXCR7 mRNA levels among the three groups of patients.</p><p><b>RESULTS</b>All samples tested positive for CXCR7 mRNA. The quantitative results showed that the CXCR7 mRNA levels were highest in laryngeal cancer and lowest in maxillary sinus carcinoma neoplasms, although there was no significant difference among the three samples.</p><p><b>CONCLUSION</b>CXCL12 and its receptor CXCR7 may contribute to eosinophilic inflammation in patients with chronic sinusitis and nasal polyps. Our results also suggest that CXCR7 may play a role in the progression, metastasis and angiogenesis of otorhinolaryngologic tumours.</p>

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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Biomarcadores de Tumor , Genética , Carcinoma de Células Escamosas , Genética , Metabolismo , Patología , Progresión de la Enfermedad , Regulación Neoplásica de la Expresión Génica , Neoplasias de Oído, Nariz y Garganta , Genética , Metabolismo , Patología , ARN Neoplásico , Genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Receptores CXCR , Genética

RESUMEN

OBJECTIVE: The objective of this study was to clarify the outcomes of craniofacial resection for locally advanced maxillary sinus carcinoma classified as T4 and to present methods for managing cases involving the skull base. STUDY DESIGN: Case series with chart review. SETTING: Tertiary university hospital. SUBJECTS AND METHODS: We performed anterolateral craniofacial resection in en bloc fashion for locally advanced maxillary sinus carcinoma at stage T4. Participants comprised 40 patients with T4 maxillary sinus carcinoma treated between 1992 and 2011. Surgical outcomes were analyzed retrospectively. RESULTS: Forty patients with stage T4a (n = 26) or stage T4b (n = 14) were included in this study. Five-year overall and disease-free survival rates for the 40 patients with T4 maxillary sinus carcinoma were 62.7% and 52.6%, respectively. Cavernous sinus involvement correlated significantly with worse prognosis (P = .012). In 35 cases without cavernous sinus involvement, previous treatment (P = .017) and positive margins (P = .019) correlated significantly with worse prognosis, and 5-year overall and disease-free survival rates were 72.4% and 55.3%, respectively. CONCLUSION: This study only included cases of locally advanced maxillary sinus carcinoma classified as T4. Considering the advanced stage, our study suggests relatively favorable outcomes and the importance of managing the cavernous sinus in en bloc resections of malignant skull base tumors. Craniofacial resection in en bloc fashion achieved good survival rates.

Asunto(s)

Neoplasias del Seno Maxilar/cirugía , Base del Cráneo/patología , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adulto , Anciano , Carcinoma Adenoide Quístico/mortalidad , Carcinoma Adenoide Quístico/patología , Carcinoma Mucoepidermoide/mortalidad , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Seno Cavernoso/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/mortalidad , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento