Sheen Yen Ting, Chen Yu Yuan, Sheen Maw Chang
Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int J Surg Case Rep. 2020;71:82-84. doi: 10.1016/j.ijscr.2020.04.034. Epub 2020 May 11.
We present a difficult case of huge squamous cell carcinoma (SCC) of lower lip that was successfully treated by intra-arterial infusion with methotrexate (MTX).
This 42-year-old female patient present with a fungating lower lip SCC of approximately 10 × 5 cm in size. MTX 25 mg was infused continuously to each side of external carotid artery every 24 h using two portable pumps. Totally, MTX 300 mg was given over 6 days. After treatment initiation, the tumor shrank dramatically and disappeared completely 2 months after the therapy. The patient was now recurrence-free at the recent follow-up 4 and half years after therapy.
Intra-arterial infusion chemotherapy has the advantage of delivering a high concentration of anticancer drug to the lesion to induce a rapid shrinkage of the tumor and the side effects are limited. Intra-arterial infusion with MTX achieves good tumor response to lower lip cancer with excellent anatomical and functional preservation.
This therapy may be a treatment option in lower lip cancers with unresectable lesions, or in those patients who are unwilling to undergo resection.
我们报告一例下唇巨大鳞状细胞癌(SCC)的疑难病例,该病例通过动脉内灌注甲氨蝶呤(MTX)成功治愈。
该42岁女性患者患有下唇溃疡性SCC,大小约为10×5厘米。使用两个便携式泵,每24小时向双侧颈外动脉各持续输注25毫克MTX。6天内共给予MTX 300毫克。治疗开始后,肿瘤显著缩小,并在治疗2个月后完全消失。在治疗后4年半的最近一次随访中,患者无复发。
动脉内灌注化疗的优点是能将高浓度抗癌药物输送至病变部位,使肿瘤迅速缩小,且副作用有限。动脉内灌注MTX对下唇癌有良好的肿瘤反应,能出色地保留解剖结构和功能。
对于无法切除的下唇癌或不愿接受手术切除的患者,这种治疗方法可能是一种治疗选择。