Ii Noriko, Fuwa Nobukazu, Toyomasu Yutaka, Takada Akinori, Nomura Miwako, Kawamura Tomoko, Sakuma Hajime, Nomoto Yoshihito
Department of Radiation Oncology, Mie University Hospital, 2-174 Edobashi, Tsu-shi, Mie, 514-8507, Japan.
Department of Radiation Oncology, Ise Red Cross Hospital, 471-2 Funae 1 choume, Ise-shi, Mie, Japan.
Cardiovasc Intervent Radiol. 2017 Jul;40(7):1099-1104. doi: 10.1007/s00270-017-1635-z. Epub 2017 Mar 29.
The purpose of this study was to describe a novel system for treating advanced head and neck cancer consisting of an external carotid arterial sheath (ECAS) and a microcatheter to inject drugs retrogradely into multiple feeding arteries through the superficial temporal artery (STA).
Four consecutive patients with head and neck cancer that had more than one feeding artery were enrolled in this study. The ECAS was made of polyurethane and surface-coated with heparin resin to prevent thrombus formation, allowing it to remain in place for a prolonged period of time. The ECAS was inserted through the STA, and its tip was placed between the maxillary artery and facial artery. The tumor-feeding arteries were selected using a hooked-shaped microcatheter through the ECAS.
A total of 13 target arteries were selected in the four patients. The microcatheter inserted via the ECAS was used to catheterize ten arteries (five lingual arteries and five facial arteries). The remaining three lingual arteries were directly selected by the catheter without ECAS. All of the target arteries were able to be catheterized superselectively. The technical success rate was 100%. Vascular occlusion, which might have been caused by the ECAS, was observed in one patient. No neurologic toxicities occurred.
This ECAS system is a new approach for retrograde superselective intra-arterial chemotherapy that covers the entire tumor with anticancer drugs. It has the potential to increase the effectiveness of therapy for advanced head and neck cancer.
Level 4, Case Series.
本研究旨在描述一种用于治疗晚期头颈癌的新型系统，该系统由颈外动脉鞘（ECAS）和微导管组成，可通过颞浅动脉（STA）将药物逆行注入多条供血动脉。
本研究纳入了4例连续的头颈癌患者，这些患者均有不止一条供血动脉。ECAS由聚氨酯制成，表面涂有肝素树脂以防止血栓形成，使其能够长时间留置。将ECAS通过STA插入，其尖端置于上颌动脉和面动脉之间。通过ECAS使用钩形微导管选择肿瘤供血动脉。
4例患者共选择了13条靶动脉。通过ECAS插入的微导管用于插管10条动脉（5条舌动脉和5条面动脉）。其余3条舌动脉直接由无ECAS的导管选择。所有靶动脉均能超选择性插管。技术成功率为100%。1例患者观察到可能由ECAS引起的血管闭塞。未发生神经毒性。
这种ECAS系统是逆行超选择性动脉内化疗的一种新方法，可使抗癌药物覆盖整个肿瘤。它有可能提高晚期头颈癌的治疗效果。
4级，病例系列。
