| Research Abstract |
We applied 2 cycles of combination therapy with low dose chemotherapy and adoptive immunotherapy for 22 patients with maxillary sinus carcinoma (MSC). On 4th or 5th day after collection of peripheral blood mononuclear cells (PBMC), cannula were inserted retrogradely into tumor feeding artery. On the following day, cisplatin or carboplatin was injected intraarterially at 20 mg/body, 100 mg/body, respectively and 250 mg/body of 5-fluorouracil were administered on the subsequent 5 consecutive days. During the low dose chemotherapy, cytotoxic T lymphocyte (CTL) were induced from autologous PBMC using allogeneic MSC cell line and interleukin-2. After the completion of low dose chemotherapy, these in vitro-induced CTL were infused back intra-arterially to the patient, and the effects were estimated by CT scans. Subsequently, all the patients received 40 Gy-radiotherapy and then surgery on the basis of the evaluation on the three combination therapy. Of 22 patients, one and fourteen showed complete response (CR) and partial response (PR), respectively, to the chemo-immunotherapy. A total of 13 patients (55%) showed clinical CR in response to the three combined therapy. No residual tumor was confirmed histollogically in eleven of these thirteen clinical CR patients and required surgery without pitiful functional and morphological sacrifices. The two histlological PR patients occurred recurrence despite additional post-operative irradiation. In 9 clinical PR patients, surgery including orbital exenteration was carried out for one patients and the other 3 and 5 patients received maxillectomy (preserved orbital content) and Denker's operation (preserved both orbital content and palate), respectively and 7 occurred recurrence. Kaplan-Meier survival rate showed that 5 year survival rate of these patients were approximately 60%. The three combination therapy brought curative effect and good quality of life to approximately half of MSC patients.
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