Organ preservation with daily concurrent chemoradiotherapy using a new superselective intra-arterial infusion for stage III, IV tongue cancer.

Abstract

5556 Background: Combined radiotherapy and intra-arterial chemotherapy, which delivers a very high concentration of anticancer agent to the tumor, is currently used to treat advanced head and neck cancer. However, chemotherapy and radiotherapy cannot be performed simultaneously on a daily basis under conventional methods because long-term catheterization is not possible. Therefore, we developed a new method using superselective intra-arterial infusions via the superficial temporal artery and the occipital artery, and used it to perform daily concurrent chemoradiotherapy for the treatment of advanced tongue cancer. Methods: Seventy-two patients with advanced tongue cancer underwent chemoradiotherapy using this superselctive intra-arterial infusion method. Catheters were inserted superselectively to the feeding arteries of the tumor via the superficial temporal artery and the occipital artery. Long-term catheterization is possible in this method. Daily concurrent combined therapy with radiotherapy (total dose: 60 Gy), superselective intra-arterial chemotherapy using DOC (total dose: 60 mg/m2) and CDDP (total dose: 150 mg/m2) was performed. The anticancer agent was injected in a bolus through the intra-arterial catheter simultaneously with radiotherapy. Results: No major complications were observed. Clinical efficacy was CR in 64 (88.9 %) patients and PR in 8 (11.1 %). With a median follow-up period of 31 months (range 6 to 72 months), the overall survive rate was 74.8 % and the local control rate was 93.7%. Conclusions: This superselective intra-arterial infusion allows for long-term catheterization, unlike the conventional method, so that chemotherapy can be performed simultaneously with radiotherapy on a daily basis. This treatment method promises to be the strategy of choice for the treatment of advanced tongue cancer.