Kanno Chihiro, Masubuchi Tatsuo, Fushimi Chihiro, Kitani Yosuke, Niwa Kazutomo, Takeishi Etsuro, Kaneko Tetsuharu, Yamazaki Morio, Hasegawa Hiroshi, Kamata Shin-Etsu, Miura Kouki, Tada Yuichiro
Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Oral and Maxillofacial Surgery, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan.
Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.
Oral Oncol. 2020 Oct;109:104873. doi: 10.1016/j.oraloncology.2020.104873. Epub 2020 Jun 27.
Intra-arterial chemoradiotherapy via a superficial temporal artery is reportedly a useful organ-preserving treatment for maxillary sinus squamous cell carcinoma. This study aimed to determine whether blood flow modification facilitates sufficient drug delivery to the entire carcinoma via the maxillary artery alone, even for advanced tumors.
A retrospective study of 10 patients who were diagnosed with locally advanced carcinoma (4 [40%] at stage T3, 5 [50%] at T4a, and 1 [10%] at T4b) from August 2016 to July 2018, with tumor blood flow from both the maxillary and facial arteries, was conducted. Patients underwent intra-arterial chemoradiotherapy, which involved chemotherapy with weekly cisplatin administration (40 mg/m) and radiotherapy (70 Gy/35 fr), with facial artery ligation. The success rate of blood flow modification, as well as its therapeutic effects and safety, were evaluated, with a median follow-up period of 14.4 months (range: 12.3-35 months).
The blood flow surrounding the tumor was changed from both the maxillary and facial arteries to the maxillary artery alone in all patients. A median of 9 chemotherapy courses (range: 8-10) were administered; the median total cisplatin dose was 350 mg/m (range: 320-360 mg/m). Radiotherapy of 70 Gy/35 fr was used to treat all patients. Grade 3 oral mucositis (80%) and irradiation field dermatitis (40%) were observed. In all patients, complete response was achieved, and local recurrence was not observed for at least 1 year.
Simplifying the blood flow around the tumor facilitates more standardized intra-arterial chemoradiotherapy via a superficial temporal artery procedure.
据报道，经颞浅动脉进行动脉内放化疗是一种对上颌窦鳞状细胞癌有用的保留器官的治疗方法。本研究旨在确定血流改变是否有助于仅通过上颌动脉就将足够的药物输送到整个癌组织，即使对于晚期肿瘤也是如此。
对2016年8月至2018年7月诊断为局部晚期癌（T3期4例[40%]，T4a期5例[50%]，T4b期1例[10%]）且肿瘤血供来自上颌动脉和面部动脉的10例患者进行回顾性研究。患者接受动脉内放化疗，包括每周静脉注射顺铂（40mg/m²）化疗和放疗（70Gy/35次），同时结扎面部动脉。评估血流改变的成功率及其治疗效果和安全性，中位随访期为14.4个月（范围：12.3 - 35个月）。
所有患者肿瘤周围的血流均从来自上颌动脉和面部动脉转变为仅来自上颌动脉。中位给予9个化疗疗程（范围：8 - 10个）；顺铂总剂量中位数为350mg/m²（范围：320 - 360mg/m²）。所有患者均采用70Gy/35次的放疗。观察到3级口腔黏膜炎（80%）和照射野皮炎（40%）。所有患者均达到完全缓解，至少1年内未观察到局部复发。
简化肿瘤周围的血流有助于通过颞浅动脉手术进行更标准化的动脉内放化疗。
