Intra-arterial Versus Intravenous Chemoradiotherapy for Maxillary Sinus Squamous Cell Carcinoma

Abstract

Abstract Background The surgical treatment of maxillary sinus cancer may be declined by patients from a functional and cosmetic point of view. Treatment methods other than surgery include intra-arterial and intravenous chemoradiotherapy. The purpose of this study was to evaluate the utility of intra-arterial chemoradiotherapy (RADPLAT) compared with that of intravenous chemoradiotherapy for patients with squamous cell carcinoma of the maxillary sinus (MS-SCC). Methods We retrospectively reviewed the records of 22 patients with MS-SCC histologically confirmed from January 2008 to January 2021. The patients underwent RADPLAT or intravenous chemoradiotherapy. Cumulative survival was analyzed using the Kaplan-Meier method; we specifically analyzed overall survival (OS), progression-free survival (PFS), and locoregional recurrence-free survival (LRFS). Results One patient (5%) was diagnosed with T2 disease, 5 (23%) with T3 disease, and 16 (72%) with T4 disease. The median follow-up time was 29.5 months. Seventeen patients underwent RADPLAT, and 5 patients underwent intravenous chemoradiotherapy with Cisplatin (CDDP). Nine patients each experienced grade 3 toxicity during the two treatments. The 3-year OS, PFS, and LRFS rates of patients who underwent RADPLAT were 82%, 65%, and 77%, respectively. The 3-year OS, PFS, and LRFS rates of patients who underwent intravenous chemoradiotherapy with CDDP were 60%, 20%, and 20%, respectively. Only the LRFS rate was statistically significant (p=0.029). Conclusions This study suggests that RADPLAT is more useful than intravenous chemoradiotherapy in terms of local control in treating MS-SCC patients who refuse surgery.