Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Oral and maxillofacial surgeryRetrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2-4N0 tongue cancer: control of occult neck metastasis
Section snippets
Patients
Between August 2006 and March 2015, 97 patients with tongue SCC were treated with retrograde superselective intra-arterial CRT. Of these, 42 patients (29 male and 13 female; median age 63.5 years; age range, 34-87 years) with late T2 (>3 cm), T3, or T4a N0M0 underwent intra-arterial CRT (Table I). All patients were primary cases and had not received previous chemotherapy, radiotherapy, or surgery. The primary lesion and cervical lymph nodes were assessed by enhanced computed tomography (CT),
Treatment results
The median follow-up period was 46.5 months (range, 8-105 months). After retrograde superselective intra-arterial CRT, primary tumor CR was achieved in 42 cases (100%). Three of 42 cases (7.1%) showed local recurrence during follow-up. Delayed neck metastasis was detected in 5 cases (11.9%): 2 T2, 1 T3, and 2 T4a (Table II). In 4 of 5 cases, delayed neck metastasis was observed in the neck area that had no perfusion of anticancer drugs. In the other case, both the primary lesion and neck showed
Discussion
Superselective intra-arterial infusion for head and neck cancer has the advantage of delivering a high concentration of anticancer drugs to the tumor. Lee et al.14, 15 reported superselective intra-arterial chemotherapy via the femoral artery by the Seldinger method. Robbins et al.16, 17 reported the effectiveness of rapid intra-arterial administration of high-dose CDDP combined with radiotherapy and sodium thiosulfate neutralization. We developed a regimen of retrograde superselective
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Cited by (14)
Clinical and histopathologic effects of neoadjuvant intra-arterial chemoradiotherapy with cisplatin in combination with oral S-1 on stage III and IV oral cancer
2022, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyCitation Excerpt :Histopathologic examination revealed that 11 (68.8%) of 16 patients with positive cervical lymph node metastasis had grade 2 or 3 disease, which indicated that intra-arterial chemotherapy had a favorable effect. In combination with RT, intra-arterial chemotherapy targeting the main arteries may avoid neck dissection for lymph node metastases up to level III.19 Reportedly, even when intra-arterial chemotherapy targets only the primary lesion, it may migrate to regional lymph nodes via the lymphatics and have a beneficial effect in the neck when used in combination with RT.20 Some reports have also suggested that superselective IACRT has a beneficial effect on cervical lymph node metastasis10,21 and achieves significantly higher platinum levels in sentinel lymph nodes when the IACRT is cisplatin-based.22
Daily concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion for locally advanced squamous cell carcinoma of the mandibular gingiva
2018, Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyCitation Excerpt :One of these 12 patients underwent salvage surgery, but the other 11 patients were free of neck recurrence after intra-arterial CRT during the follow-up period. The lower rate of neck recurrence after this treatment can be explained by the following 3 reasons: irradiation to the neck; intra-arterially injected anticancer drugs passed into sentinel lymph nodes via lymphatic channels [15]; and perfusion of anticancer drugs to the neck through the intra-arterial infusion [16,17]. Uehara et al [16] reported that metastatic lymph nodes had completely disappeared in 83.3% of patients treated with retrograde intra-arterial CRT.
Chemoradiotherapy using retrograde superselective intra-arterial infusion for tongue cancer: Analysis of therapeutic results in 118 cases
2018, Oral OncologyCitation Excerpt :Superselective intra-arterial chemotherapy has the advantage of delivering a high concentration of the anticancer agents to the tumor, and this method can be used to provide daily concurrent CRT. Our treatment results of intra-arterial CRT for locally advanced oral SCC have been reported to be similar to those of surgery, suggesting the usefulness of this treatment modality [6–9]. In the present study, the therapeutic results and rate of organ preservation were investigated in 118 patients with stage II, III, and IV tongue SCC treated with intra-arterial CRT in a single-institution, retrospective analysis.
Ultrasound-guided microwave ablation in the treatment of early-stage tongue cancer
2022, Frontiers in Oncology