Fuwa Nobukazu, Kodaira Takesi, Furutani Kazuhisa, Tachibana Hiroyuki, Nakamura Tatsuya, Nakahara Rie, Tomoda Takuya, Inokuti Haruo, Daimon Takashi
Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan.
Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):1090-100. doi: 10.1016/j.ijrobp.2008.02.021. Epub 2008 Apr 12.
To retrospectively investigate the therapeutic results of arterial injection therapy by way of the superficial temporal artery for 88 cases of Stage III and IV (M0) tongue cancer and to clarify the factors that affected the therapeutic results.
We administered intra-arterial chemoradiotherapy by continuous infusion of carboplatin in 39 patients between January 1993 and July 2002. Systemic concurrent chemotherapy was given to 19 of these patients. We administered intra-arterial chemoradiotherapy with cisplatin with sodium thiosulfate to 49 patients between October 2002 and December 2006. Concurrent systemic chemotherapy was given to 38 of these patients.
The 3-year local control rate was 72% (T2-T3, 80%; and T4, 48%), and the 3-year survival rate was 57% (Stage III, 67%; Stage IV, 43%). On univariate analysis, age, T stage, N stage, overall stage, systemic chemotherapy, difference in intra-arterial chemotherapy, and performance status had a significant effect on survival. On multivariate analysis, N stage, systemic chemotherapy, difference in intra-arterial chemotherapy, and artery selected had a significant effect on survival.
The therapeutic results of intra-arterial chemoradiotherapy using the superficial temporal artery were not inferior to the results of surgery. In particular, the results of arterial injection therapy using cisplatin with sodium thiosulfate were excellent, and we believe it will be a new therapy for advanced tongue cancer.
回顾性研究经颞浅动脉进行动脉注射治疗88例Ⅲ期和Ⅳ期(M0)舌癌的疗效,并阐明影响疗效的因素。
1993年1月至2002年7月,我们对39例患者持续输注卡铂进行动脉内放化疗。其中19例患者同时进行全身化疗。2002年10月至2006年12月,我们对49例患者使用顺铂与硫代硫酸钠进行动脉内放化疗。其中38例患者同时进行全身化疗。
3年局部控制率为72%(T2 - T3期,80%;T4期,48%),3年生存率为57%(Ⅲ期,67%;Ⅳ期,43%)。单因素分析显示,年龄、T分期、N分期、总分期、全身化疗、动脉内化疗差异及体能状态对生存率有显著影响。多因素分析显示,N分期、全身化疗、动脉内化疗差异及所选动脉对生存率有显著影响。
经颞浅动脉进行动脉内放化疗的疗效不低于手术治疗。特别是使用顺铂与硫代硫酸钠进行动脉注射治疗的效果极佳,我们认为这将成为晚期舌癌的一种新疗法。