Osteogenic Sarcoma of the Maxilla: Neutron Therapy for UnresectableDisease

[摘要] Purpose.To present a case study involving the use of fast neutrontherapy to treat an extensive unresectable osteogenic sarcoma arising fromthe left maxilla.Patient.A 14-year-old male presented with a massive tumor producingsevere distortion of his facial structures. He had already received six courses ofchemotherapy, which had reduced his pain, but had not measurably reduced the tumor.Methods.The patient was treated with 66 MeV fast neutrons to a doseof 20.4 Gy in 13 fractions over 35 days.Results.CT assessments indicate gradually increasing calcificationand noticeable reduction of soft-tissue disease in the frontal sinus, orbit and maxillaryantrum.There has been some recontouring of the facial structures.The boy conducts anactive life, has no pain, and feels well. He was 17 years old at the last follow-up.Discussion.Fast neutrons have a greater biological effectivenessthan conventional photon beams. Their use has been associated with improved chancefor local control of unresectable disease.This case illustrates their effectiveness incontrolling an unusual and aggressive osteogenic sarcoma of the facial bone and sinuses.

[学科分类] 肿瘤学