Concomitant Intra-arterial Chemotherapy and Radiation Therapy for Carcinoma of the Oropharynx

Abstract

Our treatment of carcinoma of the oropharynx has basically been chemoradiotherapy or preoperative radiation therapy. Selective continuous intra-arterial chemotherapy with concurrent radiotherapy has been performed with the aim of organ preservation and improved local control, especially for lateral or superior wall type lesions, and lesions of other subsites (anterior or posterior wall type) have been treated with preoperative radiation therapy with or without chemotherapy. The focus of the present study was to determine whether use of this intraarterial chemotherapy approach improves the outcome of oropharyngeal cancer . A total of 47 patients with squamous cell carcinoma of the oropharynx were treated at Mie University between 1985 and 1998, and all of them have been followed-up for at least 2 years . Thirty-seven of the 47 patients had lateral or superior wall type lesions, and they were divided into two groups for evaluation in this study. The 19 patients in the intra-arterial group were treated by intra-arterial chemotherapy with concurrent radiotherapy, and they were compared with the other 18 patients, who received another form of treatment (control group). In the control group, eight patients were treated by radiation therapy alone and 10 patients were treated by surgery. A complete response rate of 68% was achieved at the primary site in the intra-arterial group. The local control rate was 15/19 (79%) in the intra-arterial therapy group and 9/18(50%) in the control group. The 5-year disease-free survival rates have been 54% and 53%, respectively. The regional control rates have been similar in both groups, but there have been six deaths from distant metastasis in the intra-arterial therapy group and one in the control group. These results indicate that intra-arterial therapy requires further investigation.