Ohtani Akemi, Saito Masato, Hirokawa Naoki, Okuda Hiroki, Sato Hiroki, Nitta Kenichiro, Mafune Shoh, Miyazaki Akihiro, Dehari Hironari, Someya Masanori
Department of Radiology, Sapporo Medical University School of Medicine, South 1 West 17, Chuo-Ku, Sapporo City, Hokkaido 060-8556, Japan.
Department of Diagnostic Radiology, KKR Sapporo Medical Center, 3-40 Hiragishi 1-6, Toyohira-Ku, Sapporo City, Hokkaido 062-0931, Japan.
Radiol Case Rep. 2024 Nov 6;20(1):560-565. doi: 10.1016/j.radcr.2024.10.081. eCollection 2025 Jan.
Most patients with head and neck cancers struggle with their treatment, particularly those with recurrent cancer. However, there is no consensus on effective treatments for recurrent head and neck cancer. Recurrent cases are often challenging to treat because performing both reirradiation and surgical intervention can occasionally be difficult. This report describes the effective cisplatin intra-arterial chemotherapy with oral S-1 for a recurrent case of maxillary gingival cancer (rT4bN1M0, rStage ⅣB). The patient who had undergone chemoradiotherapy 13 years ago and achieved complete response (CR) was referred to us due to recurrence. His recurrent lesions were located on the left maxillary bone, and a metastatic cervical lymph node was detected. We approached the feeder of the locoregional recurrence site using Seldinger's technique and repeated the cisplatin intra-arterial chemotherapy 5 times. As a result, we achieved a complete response, including he regional metastatic lymph node, without radiation or surgery. Notably, although we infused the anticancer drug into the feeder of the locoregional metastatic area, we noticed its effect on the metastatic cervical lymph node. Initially, neck dissection following intra-arterial chemotherapy had been planned; however, owing to the high effectiveness of the treatment, the subsequent surgery was deemed unnecessary. No evidence of recurrence has been observed during the 2.5-year follow-up period. In the future, intra-arterial chemotherapy can be an alternative option for patients with recurrent head and neck cancers, and our result seems to be enough to indicate that possibility.
大多数头颈癌患者在治疗过程中面临困难，尤其是那些患有复发性癌症的患者。然而，对于复发性头颈癌的有效治疗方法尚无共识。复发病例的治疗往往具有挑战性，因为再次放疗和手术干预有时都很困难。本报告描述了顺铂动脉内化疗联合口服S-1治疗一例复发性上颌牙龈癌（rT4bN1M0，rStage ⅣB）的有效性。该患者13年前接受了放化疗并获得完全缓解（CR），因复发前来就诊。其复发病变位于左上颌骨，并检测到一个转移性颈部淋巴结。我们采用Seldinger技术进入局部复发部位的供血动脉，并重复进行了5次顺铂动脉内化疗。结果，我们实现了完全缓解，包括区域转移性淋巴结，无需放疗或手术。值得注意的是，尽管我们将抗癌药物注入局部转移区域的供血动脉，但我们注意到它对转移性颈部淋巴结有效果。最初，计划在动脉内化疗后进行颈部清扫；然而，由于治疗效果显著，后续手术被认为没有必要。在2.5年的随访期内未观察到复发迹象。未来，动脉内化疗可能成为复发性头颈癌患者的一种替代选择，我们的结果似乎足以表明这种可能性。
