Clinical Observation Of The Long Term Survivors After Treatment For The Maxillary Malignancies

Abstract

Of the 1102 cases of nasal-and paranasal malignancies, life condition of the long term survivors was studied. The total number of patients were 258, of which 87 cases have been observed for 5–9 years, 149 for 10–19 years and 22 for more than 20 years. The causes of the patients’ death which occurred during the observation period were double cancer, apoplexy, decrepitude etc. As the focus of the apoplexy occurred more frequently on the side of maxillary malignancies, it could be related with the late effect of radiation therapy. The case with no symptom or with slight symptom in the performance status amounted to 80% of the subjects studied (258 cases), however, the percentages relative to the number of all registered cases (1102 cases) were 29.1% in the group of 5 years observation period, 22. 9% in 10 years group and 3.4% in more than 20 years group, respectively. The results suggest the severe circumstance of this disease. The first factor limiting everyday life was the aging of the patients and the second was the radiation cataract. The cataract always occurred on the affected side, and 87.9% cases lost their sight in 10 years after the treatment. Even on the eye of the healthy side, the intact vision was found only in 65. 8% of 10 years survivors. These observations showed that our recent therapy in adequate, but gave a warning in the way to select the indication patients for the radiotherapy. It is most important to avoid the overdosis, to decide the appropriate field and protector, and to reduce the radiation dose on the eye of the healthy side. As far as the total maxillectomy is concerned, further effort must be given for deciding the cutting margin, and for improving the operation method. Cooperation with plastic surgeon is also suggested. After the operation, attention should be paid to practice the mouth opening and to treat the middle ear effusion. © 1987, The Oto-Rhino-Laryngological Society of Japan, Inc. All rights reserved.