口腔癌に対する制癌剤の動脈内挿管注入法の臨床的, ならびに実験的研究

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Administration of anti-cancer drugs for oral cancer may be restricted within the area of adjuvant therapy. There is, however, no doubt that it is an important method next to operation and irradiation. In treating oral cancers in our department since 1964, we have been testing a therapy plan, in which intra-arterial infusion through the arteria temporalis superficialis of the affected side preceeds, and operation and/or irradiation follows depending of the case. The author have studied the fifty-three cases treated by intra-arterial infusion of various drugs in the Second Department of Oral Surgery, Kyushu Dental College, between 1964 and 1969. The author has studied the correlation between the treatment method and the result ; the clinical findings at the first examination and the findings of the pathological examinations of the samples of small tissue section and the treatment result. In addition, experimental oral cancer was created by transplanting Vx2 carcinoma in the buccal masticatory muscles of rabbits and anti-cancer drugs (MT-C or BLM) were intra-arterially infused. As a result of histopathological examinations of the effect, the following conclusions were obtained. I. Clinical study a. The approximate survival rate of the 53 cases of intra-arterial infusion was 35.3%. (33.3% for single treatment group by intra-arterial infusion and 40.0% for combined treatment group). The treatment results obtained were better than those reported by others. Significance of our therapy plan was thus proved. The combined treatment method of intra-arterial infusion followed by surgery or irradiation, in particular, was superior in the treatment results. b. Comparative studies by treatment method was undertaken of the treatment result, the occurrence sites, the clinical findings of clinical progress, the histological type by the samples of small tissue sections for pathological diagnosis, the architecure of cancerous parenchyme, histopathological findings of stroma reactions. As a result, it was indicated that the combined treatment method, when compared with the single treatment, excelled somewhat in the treatment results. c. Significance of selective administration of a suitable, anti-cancer drug by screening test was recognized. Furthermore, the fact that better treatment results were obtained in the cases treated by the combined method in addition to the selective administration is indicative of direction for treating oral cancers. II. Experimental Study a. The transplanted tumors gradually developed daily, and reached the size of a child's fist by thirty days after transplantation. b. Comparing with the control group, a restriction in the growth was clearly observed in the experiment groups and the tumors were smaller than those of the control group. c. No distinct difference in the sizes of tumors was observed between the MT-C administered group and the BLM administered group of the experiment groups. d. With an increase in the number of administration, compared with the control group, degenerative changes such as concentration swelling, disintegration and decrease in sensetivity to staining of the nucleus and vacuolation of cytoplasma, were observed clearly. No distinct difference in such changes was observed between the MT-C administered group and the BLM administered group. e. MT-C administered group showed a somewhat stronger trend for fibrosis of the valamentum than BLM administered group. No distinct difference in fibrous stroma reactions and cellular stroma reactions was observed between the MT-C administered group and the BLM administered group.