Photoimmunotherapy with surgical navigation and computed tomography guidance for recurrent maxillary sinus carcinoma

Photoimmunotherapy (PIT) using lasers to target treatment areas is effective for unresectable locally advanced or unresectable locoregionally recurrent head and neck cancer; however, there are only two devices to target the treatment area. One illuminates tumour tissue through a needle, and the other illuminates tumour tissue superficially. Treating lesions surrounded by bone, such as in maxillary sinus cancer, is difficult. We report the first case of PIT for unresectable recurrent maxillary sinus cancer employing surgical navigation and computed tomography guidance in a 56-year-old man. Although he underwent concurrent chemoradiotherapy for cT4bN0M0 maxillary sinus cancer, the tumour recurred at the primary site 6 months post treatment. Chemotherapy was performed for approximately 1 year; however, the tumour progressed. The tumour involved the anterior wall of the maxillary sinus and caused bone destruction; thus, we believed that PIT with a needle device was possible if the puncture was carefully performed. We used a surgical navigation system for neurosurgery and computed tomography guidance to ensure that intraoperative punctures were accurately performed. The operation time was 1 h 52 min and the treatment was completed as planned. Tumour necrosis and volume reduction were obtained with no severe adverse events, which reduced the patient's pain. & COPY; 2022 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.

光免疫疗法（PIT）利用激光靶向治疗区域，对无法切除的局部晚期或无法切除的局部区域复发性头颈部癌症有效；然而，只有两种用于靶向治疗区域的设备。一种通过针照射肿瘤组织，另一种对肿瘤组织进行表面照射。治疗被骨头包围的病变，比如上颌窦癌，是困难的。我们报告了第一例在一名56岁男性中利用手术导航和计算机断层扫描引导对无法切除的复发性上颌窦癌进行光免疫疗法的病例。尽管他因cT4bN0M0上颌窦癌接受了同步放化疗，但在治疗6个月后肿瘤在原发部位复发。进行了大约1年的化疗，但肿瘤仍进展。肿瘤累及上颌窦前壁并导致骨质破坏；因此，我们认为如果小心进行穿刺，使用针式设备进行光免疫疗法是可行的。我们使用了神经外科手术导航系统和计算机断层扫描引导，以确保术中穿刺准确进行。手术时间为1小时52分钟，治疗按计划完成。获得了肿瘤坏死和体积缩小，且没有严重不良事件，这减轻了患者的疼痛。© 2022日本耳鼻咽喉头颈外科学会。由爱思唯尔公司出版。保留所有权利。