Vol.96 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.5 May 2003
Superselective Arterial Infusion and
Concomitant Radiotherapy
Akihiro Homma, Fumiyuki Suzuki, Yukio Inuyama and Satoshi Fukuda
(Hokkaido University)
Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment.
Patients and methods: Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65Gy/26f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1).
Results: During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3％) of 29 patients. Eleven (37.9％) patients died of disease, and three (10.3％) were alive with disease. In twenty-one patients (72.4％) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, MRSA pneumonia, sepsis, tetraplasia, and osteoradionecrosis.
Conclusions: We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed.
Key words : superselective, arterial infusion, radiotherapy, head and neck cancer