Nakashima Torahiko, Yasumatsu Ryuji, Toh Satoshi, Shiratsuchi Hideki, Kamitani Takeshi, Shioyama Yoshiyuki, Nakamura Katsumasa, Komune Shizuo
Departments of Otolaryngology-Head and Neck Surgery, Kyushu University, Fukuoka, Japan.
Case Rep Oncol. 2011 Sep;4(3):492-8. doi: 10.1159/000332759. Epub 2011 Sep 3.
Intra-arterial (IA) chemotherapy for head and neck cancer is effective and multiple IA concurrent chemoradiation (CCRT) protocols have been reported. However, the role of IA CCRT in the multimodality treatment of head and neck cancer is still controversial. We have treated 5 cases of unresectable T4 maxillary sinus squamous cell carcinoma with IA cisplatin (CDDP) and docetaxel (DOC) and CCRT with oral S-1. We report our experience and the effectiveness and feasibility of this combination as an alternative choice of treatment for inoperable head and neck cancer. The patients received an IA infusion of CDDP (50-70 mg/m(2)) and DOC (50-60 mg/m(2)) through the femoral artery, followed by CCRT with oral S-1. The IA infusion was repeated up to 3 times and the radiation was dosed at up to 60-70 Gy. Complete response was achieved in 4 patients and partial response in one, giving an overall response rate of 100%. The most common grade 3 or 4 toxicities were anorexia (80%), mucositis (80%) and leukopenia (80%), all of which were manageable. CCRT with IA CDDP/DOC and oral S-1 was effective and tolerated. Although preliminary, the response rate encourages further pursuit and definitive evaluation of this combination for the treatment of inoperable advanced head and neck cancer.
头颈部癌的动脉内（IA）化疗是有效的，并且已有多种IA同步放化疗（CCRT）方案的报道。然而，IA CCRT在头颈部癌多模式治疗中的作用仍存在争议。我们采用IA顺铂（CDDP）和多西他赛（DOC）以及口服S-1进行CCRT治疗了5例无法切除的T4上颌窦鳞状细胞癌。我们报告了我们的经验以及这种联合治疗作为不可手术头颈部癌替代治疗选择的有效性和可行性。患者通过股动脉接受IA输注CDDP（50 - 70 mg/m²）和DOC（50 - 60 mg/m²），随后口服S-1进行CCRT。IA输注重复进行多达3次，放疗剂量高达60 - 70 Gy。4例患者达到完全缓解，1例部分缓解，总缓解率为100%。最常见的3级或4级毒性反应为厌食（80%）、黏膜炎（80%）和白细胞减少（80%），所有这些毒性反应均可控制。IA CDDP/DOC联合口服S-1进行CCRT是有效的且耐受性良好。尽管是初步研究，但缓解率鼓励进一步探索并对这种联合治疗不可手术的晚期头颈部癌进行确定性评估。
