Intra-arterial chemotherapy using docetaxel and cisplatin + RT with radiomodification in combined treatment of patients with locally advanced SCC of the oral cavity

Abstract

16543 Background: Our previous studies of using intra-arterial induction chemotherapy in locally advanced SCCHN have showed a low level of toxicities, we haven't experienced any III grade toxicity, there was only 18,8% of grade I and II leucopenia. So this method allows intensify chemoradiotherapy. The addition of radiomodificant agent to standard RT increases its response rate. In our study we have used radiomodification with Arglabin, which showed a good results in different studies performed in Kazakhstan and Russia. To elevate the effect of intra-arterial induction chemotherapy + RT we have studied intensified preoperative chemoradiotherapy. Methods: 15 patients with previously untreated oral cancer (T3–4N0–2M0) received chemoradiotherapy by followed scheme: 1st day intra-arterial chemotherapy by catheterization of the feeding arteries of tumor through the superficial temporal artery: docetaxel - 80 mg/m2, cysplatin - 100 mg/m2, from 2nd to 21st day RT with intra-arterial radiomodification arglabin-70 mg/m2 (28 Gy by 4 Gy - 3 times week), 22nd day second course of intra-arterial chemotherapy and after RT (total dose- 60 Gy by 2 Gy 5 times week), depending on the results surgical treatment in necessary volumes. Results: The clinical effects were CR in 12 (80.0%) patients, PR in 3 (20,0%) patients. The following main toxicities of chemoradiotherapy were observed: only 1 case of grade III neutropenia, Non-hemathologic toxicity: 13% grade III mucosal events, alopecia 66,7%. All results have been confirmed by cytomorphology. All patients have being followed up. Conclusions: Using intra-arterial path of delivery allows intensify chemoradiotherapy. And adding radiomodification increases the results of combined treatment. Therefore this method needs further investigations. No significant financial relationships to disclose.