Concurrent Superselective Intra-Arterial Chemotherapy and Radiotherapy for Late-Stage Squamous Cell Carcinoma of the Temporal Bone

Abstract

This study evaluated the efficacy of concurrent superselective intra-arterial chemotherapy and radiotherapy without surgery for late-stage squamous cell carcinoma of the temporal bone, which typically has a poor prognosis. The subjects were 5 patients treated at our hospital between 2007 and 2010 for primary cancer of the temporal bone. One patient had a stage T3 tumor, and 4 patients had T4 tumors, according to the Pittsburgh staging system. All patients received irradiation with a conventional once-daily fraction of 2 Gy, and the total dose ranged from 60 to 66 Gy. Intra-arterial cisplatin via transfemoral catheterization and intravenous sodium thiosulfate were administered. The contribution of each vessel in supplying blood to the primary tumor was determined by real-time computed tomographic angiography. Three patients obtained a complete response. The same 3 patients remain alive without local recurrence (mean survival, 28 months), 1 patient died of distant metastasis without local recurrence after 19 months, and 1 patient remains alive with local recurrence. Although the small number of patients prevents comparisons with other treatments, the present study obtained good results. This may become an effective treatment for patients with late-stage squamous cell carcinoma of the temporal bone.