Nazal Kavite ve Paranazal Sinüs Tümörlerinde Radyoterapinin Sağkalıma Etkisi

Yıl 2020, Cilt: 27 Sayı: 2, 186 - 190, 01.06.2020

Rahşan Habiboğlu F. İlknur Kayalı Ferdi Aksaray

https://doi.org/10.17343/sdutfd.548255

Öz

Amaç: Nazal kavite ve
paranazal bölge tümörleri nadir görülen ve genellikle ileri evrede tanı konulan
tümörlerdir. Bu çalışma sinonazal bölge tümörlerinde histopatolojik tanının,  boyun lenf nodu tutulumunun ve tedavi
modalitelerinin sağkalıma etkisini 
araştırmak amacıyla retrospektif olarak yapılmıştır.

Materyal ve
metod:1991-2002 yılları arasında kliniğimize paranazal sinüs kanseri tanısıyla
başvuran ve tedaviye alınan 47 hastadan 37’si çalışmaya dahil edilmiştir. Hastaların
24’ü erkek, 13’ü kadındır. Medyan yaş 55’tir.Hastaların histopatolojik
tanılarının çoğunluğunu sırasıyla yassı hücreli kanser, adenoidkistik karsinom
ve baş – boyun sarkomu oluşturmaktadır.T3-T4 hasta sayısı 23 (%76.6)’dü. Beş
hastanın boyun lenf nodu tutulmuştur. Hastaların 16’sına (%43.24)  cerrahi + postoperatif radyoterapi(port),
6’sına (%16.21) cerrahi + port + kemoterapi (kt), 11’ine (%29.72) definitif
radyoterapi (rt), 4 hastaya  (10.81) rt
ardından kt uygulanmıştır.

Sonuçlar: Takip süremiz
22 aydır. 5 yıllık sağkalım oranı % 43.69 olarak bulunmuştur.Çalışmamızda boyun
lenf nodu tutulumunun sağkalımı olumsuz etkilediğini (p=0.03) , adenoidkistik
karsinomun yassı hücreli kanser ve  baş
boyun sarkomuna göre sağkalımı arttırdığını gösterdik (sırasıyla p=0.01, p=0.03
). İstatistiksel anlam içermese de  seçilen tedavi 
modalitesinin sağkalıma etkili olduğunu 
düşündürecek sonuçlara vardık.

Tartışma: Çalışmamızın
tek merkezli bir çalışma olması zaten paranazal sinüs kanserli hasta sayısının
az olmasıyla birleştiğinde yeterli hasta sayısına ulaşmayı ve homojen hasta
dağılımını engellemiştir.

Anahtar Kelimeler

radyoterapi, sağkalım, paranazal sinüs tümörleri

The Effect Of Radiotherapy On Survival In Nasal Cavity And Paranasal Sinus Tumors

Öz

Aim: Nasal cavity and
paranasal tumors are rare and usually diagnosed in advanced stage. This study
was retrospectively designed to investigate the survival effect of histopathological
diagnosis,  lymph node involvement and
treatment modalities in sinonasal  tumors.

Material and Method :, 37 patients out of 47 who had referred to our
clinic with paranasal sinus cancer between 1991-2002 were included in the study. Twenty-four patients were male and thirteen were
female. Median age was 55 years .Most  seen histopathological diagnoses were squamous
cell cancer, adenoidcystic  carcinoma,
and head and neck sarcoma, respectively. The number of patients with t3-t4  was 23 (76.6%).  There was lymph nodes involvement in five
patients. Surgical treatment + postoperative radiotherapy (port) was performed
in 16 patients (%43.24%) , surgical treatment + chemotherapy (kt) was performed
in 6 patients (16.21 %),  and definitive
radiotherapy (RT), was performed in 4 patients (10.81%)

Results: Our follow-up
period was 22 months. Five-year survival rate was 43.69%. In our study , we
showed that neck lymph node involvement negatively affects survival (p=0.03), adenoidcystic
carcinoma increases survival compared  to
squamous cell cancer and head and neck sarcoma (p=0.01, p=0.03, respectively ).
 Although it is not statistically significant, we have concluded that the
chosen treatment modality is effective on survival

Conclusion: The fact that our study being single centered combined with the low number of patients with paranasal sinus cancer prevented the number of patients and the distribution of homogenous patients.

 

 

 

 

Anahtar Kelimeler

paranasal sinus cancer, radiotherapy

Kaynakça

• Referans1Francesco Perri, Raffaele Addeo, Manuel Conson, Adriana Faiella, Giuseppina Della Vittoria Scarpati, Gabriella Tore. Locally advanced paranasal sinus carcinoma: A study of 30 patients. Oncol Lett. 2017 Mar; 13(3): 1338–1342.
• Referans 2 C.P.Sudheer, T. Dinesh Singh. Squamous cell carcinoma of maxillary sinus: a comparison of clinico-radiological staging with pre-operative staging. International Journal of Otorhinolaryngology and Head and Neck Surgery Sudheer CP et al. Int J Otorhinolaryngol Head Neck Surg. 2018 Sep; 4 (5) : 1229-1232
• Referans 3 Périé S, Meyers M, Mazzaschi O, De Crouy Chanel O, Baujat B, Lacau St Guily J Bull. Epidemiology and anatomy of head and neck cancers. Cancer. 2014 May 1; 101(5):404-10.
• Referans 4 Jose Luıs Liorente, Fernando Lopez, Carlos Suarez and Mario A. Hermsen. Sinonasal carcinoma :clinical, patological, genetic and therapeutic. advances Nat.Rev.Clin.Oncol. 2014 Aug;11(8):460-72
• Referans 5 Bradford S. Hoppe M.D, Lauren D. Stegman M.D., Ph.D, Michael J. Zelefsky M.D., Kenneth E. Rosenzweig M.D., Suzanne L. Wolden M.D., Snehal G. Patel M.D. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting—the MSKCC experience.International Journal of Radiation Oncology,Biology ,physics.Volume 67,Issue 3, 1 March 2007, pages 691-702
• Referans 6 Jhon H. Isaacs Jr.MD, Spencer Mooney MD, William M. Mendenhall M.D, James T. Parsons M.D. Cancer of the Maksillary sinus treated with surgery and/or radition therapy. The American Surgeon May 1990 vol:16 pp 327-330
• Referans 7 Pierre Lavertu M.D, Jay K. Roberts M.D,Dennis H. Kraus M.D, Howard L. Levine M.D, Benjamin G. Wood M.D, Sharon V. Medendrop MPH. Squamous cell carcinoma of the paranasal sinuses. The Cleveland Clinic Experience 1977-1986.Laryngoscope 99: November 1989
• Referans 8 Edwin P.M. Jansen M.D,Ronald B. Keus M.D, frans J.M. Hilgers M.D,Ph.D., Rick L.M. Haas M.D,I Bıng Tan M.D,Ph.D.,And Harry Bartelınk M.D.Ph.D.Int. J. Radiation Oncology Bıol. Phys. Vol.48,No:1,pp27-35, 2000
• Referans 9 T.W. Backhouse The treatment of Malignant Tumours of the Maxillary Antrum Clinical radiology 37, 1986,179-182
• Referans 10 Bijan Khademi, Azadeh Moradi, Sara Hoseini, Mohammad Mohammadianpanah. Malignant neoplasms of the sinonasal tract: report of 71 patients and literature review and analysis. Oral and Maxillofacial Surgery. December 2009, 13:191-199
• Referans 11 Mayer Zaharia, M.D.,F.R.C.R, Luis E. Salem, M.D., Rodrigo Travezan, M.D. Alfredo Moscol, M.D. A.Luis Pinillos, M.D, Carlos Farias M.D. Postoperative radiotherapy in the management of cancer of the maxillary sinus. Int. J. Radiation Oncology Bıol. Phys. November 1989 Volume 17, Issue 5, Pages 967–971
• Referans 12 Tsujii H, Kamada T, Matsuoka Y, Takamura A. The Value of Treatment Planning Using CT And An Immobilizing Shell in Radioyherapy for Paranasal Sinus Carcınomas. Int. J. Radiation Oncology Bıol. Phys. 16-1989 pp 243-249
• Referans 13 Cantù G, Bimbi G, Miceli R, Mariani L, Colombo S, Riccio S,. Lymph node metastases in malignant tumors of the paranasal sinuses: prognostic value and treatment. Arch Otolaryngol Head Neck Surg. 2008 Feb; 134 (2) : 170-7
• Referans 14 G.J. Hordijk and E.N. Brons Carcinomas of the maxillary sinus: a retrospective study. Clin. Otolaryngol. 1985, 10 , 285-288
• Referans 15 Bridger M.W. Beale F.A. & Bryce D.P. (1978) . Carcinoma of the paranasal sinuses : a review of 158 cases J. Otolaryngol. 7, 379-388
• Referans 16 Gullane P.J. & Conley J. Carcinoma of the maxillary sinus J. Otolaryngol 12, 1983 pp 141-145
• Referans 17 Scott J. Stern, MD; Helmuth Goepfert, MD; Gary Clayman, MD, DDS. Squamous Cell Carcinoma of the Maxillary Sinus. Arch Otolaryngol Head Neck Surg. 1993 ; 119 (9) : 964-969.
• Referans 18 Gülşen Pınar Soydemir and Mustafa Kandaz. Clinical Outcomes in Nasal Cavity and Paranasal Sinus Tumors: A Single Institution Experience from the Eastern Black Sea Region of Turkey J Radiat Oncol Res. 2019; 3(1): 1009.
• Referans 19 Neil Bhattacharyya, M.D. Cancer of the Nasal Cavity Survival and Factors Influencing Prognosis.ARCH OTOLARYNGOL HEAD NECK SURG/ Vol 128, Sep 2002 pp1079-1083
• Referans 20 Itami J., Uno T., Aruga M., Ode S. Squamous cell carcinoma of the maxillary sinus treated with radiation therapy and conservative surgery. Cancer 1998 ; 82 : 104-107
• Referans 21 Shibuya H. Horiuchi,J. Suzuki, S. Shioda,S Enomoto, S. Maxillary sinus carcinoma:result of radiation therapy. Int. J. Radiat. Oncol. Biol. Phys.10:1021-1026;1984
• Referans 22 Schramm V. L., Jr Myers E.N., Maroon, J.C . Anterior skull base surgery for benign and malignant disease. Laryngoscope 89:1077-1091,1979
• Referans 23 Marcello Roter M Santos,João Paulo S Servato, Sérgio Vitorino Cardoso, Paulo Rogério de Faria, Ana Lúcia A Eisenberg, Fernando Luiz Dias Squamous cell carcinoma at maxillary sinus: clinicopathologic data in a single Brazilian institution with review of literature.Int J Clin Exp Pathol. 2014; 7(12): 8823–8832.
• Referans 24 Shin Hyung Park, Jeong Eun Lee,Dongbin Ahn. Outcome of definitive and postoperative radiotherapy in patients with sinonasal squamous cell carcinomas.Tumori 2015;102(4):426-432
• Referans 25 Beale F A, Garetta P G.Cancer of paranasal sinuses with particular referance to maxillary sinus cancer. J Otolaryngol 1983;12:377-82