Elective ipsilateral neck irradiation of patients with locally advanced maxillary sinus carcinoma

BACKGROUND. The current study was conducted to investigate retrospectively whether elective ipsilateral neck irradiation (EINI) is effective in contro lling subclinical neck disease in patients with locally advanced (T3 and T4 ) nonmetastatic (NO, MO) squamous cell carcinoma (SCC) of the maxilla. METHODS. Between 1987 and 1993 a total of 44 patients were treated with EIN I. The primary tumor bed was treated with 60 grays (Gy) in patients undergo ing radical maxillectomy or with 66 Gy in patients undergoing partial maxil lectomy. The ipsilateral upper and lower neck (down to the clavicle) was tr eated with either opposing anteroposterior-posteroanterior fields or apposi tional electron fields. The dose of elective neck radiotherapy was 50 Gy in 25 daily fractions. RESULTS. The 5-year and IO-year survival rates (with standard error [SE]) w ere 66% (SE 7%) and 60% (SE 8%), respectively, whereas the 5-year and 10-ye ar recurrence free survival rates both were 64% (SE 7%). The 10-year local recurrence free survival rate was 69% (SE 7%), whereas the 10-year regional recurrence free survival rate was 94% (SE 4%). Of the 2 patients who devel oped a recurrence in the neck, 1 was salvaged successfully by surgery, prod ucing an ultimate 10-year regional recurrence free survival rate of 97%. Th e 10-year distant metastasis free survival rate was 91% (SE 4%). CONCLUSIONS, The findings of the current study appear to suggest the potent ial efficacy of EINI in patients with locally advanced, nonmetastatic SCC o f the maxilla and that the high rate of control of cervical lymph nodes may lead to better overall survival than that reported in the majority of the recent series. Cancer 2000;88: 2246-51. (C) 2000 American Cancer Society.