Abstract
We have been performing the superselective transarterial infusion of high-dose cisplatin for advanced maxillary cancer since 1998 and the local control rate, disease free survival rate, and organ preservation have improved markedly compared with our former therapy. This study evaluates the effectiveness of superselective transarterial infusion therapy by using high-dose cisplatin on maxillary cancer with orbital invasion. We treated 23 patients with maxillary cancer by using superselective transarterial infusion therapy with high-dose cisplatin and concomitant radiation therapy for 10 years. Of all patients, 15 showed orbital invasion, with 11 of these tumors fed by both internal maxillary and ophthalmic arteries. In all patients, we performed superselective transarterial infusion therapy via the internal maxillary artery and/or the other feeding branches from the external carotid artery. After the operation, we determined whether a pCR had occurred by checking for the presence of viable cells. In addition, we calculated the overall survival rate, preservation rate of the eyeball, and disease-free survival rate. For all 23 patients, pCR and overall survival rates were 95.7% and 78.4%, respectively. To date, 2 of these patients died of lung metastasis without local recurrence. For the 15 patients with orbital invasion, the respective pCR and disease-free survival rates were 93.3% and 87.5%. Eyeballs were preserved in all patients, and local recurrence occurred in only 1 patient, at the inferior wall of the maxillary sinus (not in the orbit). Superselective transarterial infusion therapy with high-dose cisplatin remarkably improved the local control rate and disease-free survival rate of maxillary cancer. Even in patients with orbital invasion, a high local control rate was achieved, with preservation of the eyeball, through infusion only into branches of the external carotid artery.
Highlights
AND PURPOSE: We have been performing the superselective transarterial infusion of high-dose cisplatin for advanced maxillary cancer since 1998 and the local control rate, disease free survival rate, and organ preservation have improved markedly compared with our former therapy
2 of these patients died of lung metastasis without local recurrence
Maxillary cancer occurs in 6.4% of all head and neck cancers in Japan.[1]
Summary
We treated 23 patients with maxillary cancer by using superselective transarterial infusion therapy with high-dose cisplatin and concomitant radiation therapy for 10 years. 15 showed orbital invasion, with 11 of these tumors fed by both internal maxillary and ophthalmic arteries. We performed superselective transarterial infusion therapy via the internal maxillary artery and/or the other feeding branches from the external carotid artery. The initial subjects were 24 consecutive patients with maxillary squamous cell carcinoma examined between December 1998 and September 2007. All patients gave informed consent for superselective transarterial infusion therapy by using high-dose cisplatin with curative intent and underwent this method of treatment in our hospital. Because 1 patient left the hospital of her own free will before completion of the treatment cycle, the final set of subjects consisted of 23 patients (16 men and 7 women) with an average of 64.7 years of age (range, 32– 83 years).
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