Organ preservation with daily concurrent chemoradiotherapy using superselective intra-arterial infusion via a superficial temporal artery for T3 and T4 head and neck cancer.

Abstract

PURPOSE:

To evaluate the therapeutic results and rate of organ preservation in patients with advanced head and neck cancer treated with superselective intra-arterial chemotherapy via a superficial temporal artery and daily concurrent radiotherapy.

METHODS AND MATERIALS:

Between April 2002 and March 2006, 30 patients with T3 or T4a squamous cell carcinoma of the head and neck underwent intra-arterial chemoradiotherapy. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m(2); cisplatin, total 150 mg/m(2)) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks.

RESULTS:

The median follow-up for all patients was 46.2 months (range, 10-90 months). The median follow-up for living patients was 49.7 months (range, 36-90 months). After intra-arterial chemoradiotherapy was administered, primary site complete response was achieved in 30 (100%) of 30 cases. Seven patients (23.3%) died. Using the Kaplan-Meier method, 1-year, 3-year, and 5-year survival rates were 96.7%, 83.1%, and 70.2%, respectively, while 1-year, 3-year, and 5-year local control rates were 83.3%, 79.7%, and 73.0%, respectively. Grade 3 or 4 mucositis occurred in 20 cases (66.7%). Grade 3 toxicities included dysphagia in 20 cases (66.7%), dermatitis in 6 cases (20%), nausea/vomiting in 2 cases (6.7%), and neutropenia and thrombocytopenia in 1 case (3.3%). No osteoradionecrosis of mandible and maxillary bones developed during follow-up.

CONCLUSIONS:

Intra-arterial chemoradiotherapy using a superficial temporal artery provided good overall survival and local control rates. This combination chemoradiotherapy approach can preserve organs and minimize functional disturbance, thus contributing to patients' quality of life.

• Authors: Kenji Mitsudo, Toshio Shigetomi, Yasushi Fujimoto, Hiroaki Nishiguchi, Noriyuki Yamamoto, Hiroki Furue, Minoru Ueda, Yoshiyuki Itoh, Nobukazu Fuwa, Iwai Tohnai
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 79 Issue 5 Pg. 1428-35 (Apr 01 2011) ISSN: 1879-355X [Electronic] United States
• PMID: 20605340 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Taxoids
• Docetaxel
• Cisplatin

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Carcinoma, Squamous Cell (drug therapy, mortality, pathology, radiotherapy)
• Cisplatin (administration & dosage)
• Combined Modality Therapy (methods)
• Docetaxel
• Female
• Follow-Up Studies
• Head and Neck Neoplasms (drug therapy, mortality, pathology, radiotherapy)
• Humans
• Infusions, Intra-Arterial (methods)
• Male
• Middle Aged
• Neoplasm Staging
• Survival Rate
• Taxoids (administration & dosage)
• Temporal Arteries
• Treatment Outcome