Mitsudo Kenji, Koizumi Toshiyuki, Iida Masaki, Iwai Toshinori, Nakashima Hideyuki, Oguri Senri, Kioi Mitomu, Hirota Makoto, Koike Izumi, Hata Masaharu, Tohnai Iwai
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Japan.
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Japan.
Radiother Oncol. 2014 May;111(2):306-10. doi: 10.1016/j.radonc.2014.03.005. Epub 2014 Apr 17.
To evaluate the therapeutic results and rate of organ preservation in patients with stage III or IV oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.
One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. Treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60mg/m(2), cisplatin, total 150mg/m(2)) and daily concurrent radiotherapy (total of 60Gy) for 6 weeks.
The median follow-up for all patients was 46.2 months (range, 10-76 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1% of patients. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure in 0.9% of patients.
Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer provided good overall survival and local control.
评估采用逆行超选择性动脉内化疗及每日同步放疗治疗Ⅲ期或Ⅳ期口腔癌患者的治疗效果及器官保留率。
112例Ⅲ期和Ⅳ期口腔鳞状细胞癌患者接受了动脉内放化疗。通过颞浅动脉和枕动脉进行插管。治疗包括超选择性动脉内化疗（多西他赛，总量60mg/m²，顺铂，总量150mg/m²）及每日同步放疗（总量60Gy），持续6周。
所有患者的中位随访时间为46.2个月（范围10 - 76个月）。动脉内放化疗后，112例患者中有98例（87.5%）原发部位达到完全缓解。5年生存率和局部控制率分别为71.3%和79.3%。3级或4级毒性反应包括92.0%的患者出现黏膜炎，30.4%的患者出现中性粒细胞减少，28.6%的患者出现皮炎，26.8%的患者出现贫血，7.1% 的患者出现血小板减少。3级毒性反应包括72.3%的患者出现吞咽困难, 21.4%的患者出现恶心/呕吐, 8.0%的患者出现发热, 0.9%的患者出现肾衰竭。
逆行超选择性动脉内化疗及每日同步放疗用于Ⅲ期和Ⅳ期口腔癌可提供良好的总生存率和局部控制率。
