Ten Cases of Oral Cancers Treated With Concurrent Chemoradiotherapy Using Superselective Intra-Arterial Infusion via Superficial Temporal and Occipital Arteries

PURPOSE:Post-operative problems of advanced oral cancer are consisted from functional disorder of mastication, swallowing and speech, and cosmetic disturbance.  One of the therapeutic strategies to solve these problems and preserve organs is concurrent chemoradiotherapy using superselective intra-arterial infusion. We have applied this therapy to the treatment of advanced oral cancers from 2011. The purpose of this study was to investigate the therapeutic results and complications of treatment with this therapy for advanced oral cancers.

MATERIALS AND METHODS:Between January 2011 and March 2014, 10 patients (4 male and 6 female) with T2, T3 or T4 oral squamous cell carcinomas (T2: 2 cases, T3: 2 cases, T4: 6 cases) underwent chemoradiotherapy using superselective intra-arterial infusion via superficial temporal and occipital arteries with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of superselective intra-arterial infusions (DOC: total 60-70 mg/m², CDDP: total 150-175 mg/m²) and daily concurrent radiation therapy (2 Gy/ fraction/ day, total 60-70 Gy) for 6-7 weeks. Toxicities encountered during therapy were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.

RESULTS: The patients’ ages ranged from 37 to 74 years (mean: 58.8 years). The primary tumor sites included the tongue (5 cases), upper gingiva (4 cases) and floor of mouth (1 case). The therapy as described above was completed in 9 cases and Seldginger’s method was also need to be used in 1 case because of vascular occlusion of lingual artery. After completion of the therapy, primary site complete response was achieved in 9 of 10 cases (90%). Grade3 mucositis and dysphagia occurred in all cases (100%). Grade3 dermatitis occurred in 6 cases (60%). Grade3 nausea/vomiting occurred in 1 case (10%) All other toxicities were grade 2 or less. Five of 10 patients underwent neck dissection after the therapy. The median follow-up for all patients was 24.9 months. During follow-up, all patients were alive without disease. 

CONCLUSIONS:Chemoradiotherapy using intra-arterial infusion provided good overall survival and locoregional controls without major complications.

REFERENCES:1) Organ preservation with daily concurrent chemoradiotherapy using superselective intra-arterial infusion via a superficial temporal artery for T3 and T4 head and neck cancer. Mitsudo K, Shigetomi T, Fujimoto Y, Nishiguchi H, Yamamoto N, Furue H, Ueda M, Itoh Y, Fuwa N, Tohnai I. Int J Radiat Oncol Biol Phys. 79, 1428-35, 2011. 2) Arterial chemoradiotherapy for locally advanced tongue cancer: analysis of retrospective study of therapeutic results in 88 patients. Fuwa N, Kodaira T, Furutani K, Tachibana H, Nakamura T, Nakahara R, Tomoda T, Inokuti H, Daimon T. Int J Radiat Oncol Biol Phys. 72, 1090-1100, 2008