Daily concurrent preoperative chemoradiotherapy with docetaxel (D) and cisplatin (C) using new superselective intra-arterial infusion via superficial temporal artery (HFT method) for stage III, IV head and neck cancer

Abstract

5567 Background: Recently, combined radiotherapy and intra-arterial chemotherapy using the Seldinger method was performed for head and neck cancers. However, chemotherapy and radiotherapy cannot be performed simultaneously on a daily basis because long-term catheterization is not possible. Therefore, we developed a new method of superselective intra-arterial infusion via the superficial temporal artery (HFT method reported by Hattori, Fuwa and Tohnai) and preoperatively performed daily concurrent radiotherapy and chemotherapy with D and C using this method for stage III, IV head and neck cancer. Methods: Forty-one patients with stage III, IV oral cancer were treated. A new catheter was prepared by modifying an angiographic catheter measuring 1.35 mm in diameter. This was inserted superselectively into the feeding artery of the tumor via the superficial temporal artery using a guide wire. Long-term catheterization is possible with this method. Radiotherapy (total dose: 40 Gy) and superselective intra-arterial infusion chemotherapy using D (total dose: 60 mg/m2) and C (total dose: 100 mg/m2) were concurrently performed daily, followed by surgery. Results: In 35 patients, intra-arterial infusion was successful, but 6 intra-arterial infusions were not successful due to arterial anomalies. Toxicities in excess of grade 3 were leukopenia of 8.6%, thrombocytopenia of 2.9%, mucositis of 20.0%, and dermatitis of 14.3%. No infection was associated with catheterization and no major complications were observed. The clinical effects were CR in 29 (82.9%) patients and PR in 6 (17.1%). Pathological effects of resected tumor after surgery were pathological CR in 31 (88.6%) patients and pathological PR in 4 (11.4%). The 5-year cumulative survival rate (overall rate) was 78.8%. This rate is higher than the rate associated with conventional therapy. Conclusions: Unlike the Seldinger method, superselective intra-arterial infusion allows for long-term catheterization and thus daily concurrent chemoradiotherapy can be performed. This method holds promise for treating stage III, IV head and neck cancer. No significant financial relationships to disclose.