Abstract

Maxillary sinus carcinoma is relatively rare. Standard treatment consists in surgery followed by adjuvant radiotherapy or chemoradiotherapy. The rate of neck lymph node metastasis during follow-up is about 5-30% and this event is a poor prognostic factor. It often occurs in large primary tumours (T3-T4). The role of prophylactic neck management, selective neck dissection (SND) or elective neck irradiation (ENI), remains unclear in N0 patients. Few studies specifically discuss the role of SND. A French study suggested SND could be proposed when primary surgery is feasible, especially for high tumour volume (T3-T4). Besides, it can be useful for lymph node staging and determining radiotherapy dose and volume. The role of ENI remains unclear and controversial, although some studies suggest a potential reduction of neck relapse with it. ENI (ipsilateral level II, +/- Ib and III or bilateral neck according to the primary tumour extension) could be proposed in selected patients, especially for T3-4 disease and when SND has not been performed. Intensity-modulated radiotherapy (IMRT) should be considered, whenever feasible, to reduce toxicity.

Keywords: Maxillary sinus; Squamous cell carcinoma; Neck irradiation