Ashida Hirokazu, Kisaki Shunsuke, Michimoto Kenkichi, Yamauchi Hideomi, Baba Akira, Kessoku Hisashi, Nishiya Yukio, Kojima Hiromi, Ojiri Hiroya
Department of Radiology, The Jikei University School of Medicine, Japan.
Department of Otorhinolaryngology, The Jikei University School of Medicine Kashiwa Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2025 Jun 13;10:e20240031. doi: 10.22575/interventionalradiology.2024-0031. eCollection 2025.
To investigate the risk factors for local maxillary sinus squamous cell carcinoma recurrence/residual tumor after superselective intra-arterial cisplatin infusion and concomitant radiotherapy.
The protocol of superselective intra-arterial cisplatin infusion and concomitant radiotherapy was as follows: cisplatin was administered once per week for 7 weeks, and the dose of every procedure was 100 mg/m. Radiation was administered during the same period using intensity-modulated radiation therapy, with a total dose of 70 Gy (2 Gy/35 fractions). The risk factors for local recurrence/residual tumor were retrospectively analyzed using the Cox hazard model in 31 advanced primary maxillary sinus squamous cell carcinoma cases treated with superselective intra-arterial cisplatin infusion and concomitant radiotherapy from October 2016 to 2022. The analyzed risk factors were age, sex, T- and N-factors, invasion of the pterygoid muscle, tumor heterogeneity on imaging modality, tumor signal intensity on diffusion-weighted imaging (b = 1000), tumor-brain stem signal ratio on diffusion-weighted imaging (b = 1000), therapeutic response after the fourth infusion, and complete superselective intra-arterial cisplatin infusion and concomitant radiotherapy or not. We also compared overall survival between the recurrence/residual tumor and non-recurrence groups.
This study included 31 patients. Non-complete superselective intra-arterial cisplatin infusion and concomitant radiotherapy was the only risk factor that showed a statistically significant difference among all the analyzed risk factors. Overall survival was favorable in the non-recurrence/residual tumor group; however, there was no statistical difference compared to the recurrence/residual tumor group.
Complete superselective intra-arterial cisplatin infusion and concomitant radiotherapy was the only factor that prevented local recurrence/residual tumor. Therefore, all health careers involved in superselective intra-arterial cisplatin infusion and concomitant radiotherapy should avoid interrupting whenever possible.
探讨超选择性动脉内顺铂灌注联合放疗后上颌窦鳞状细胞癌局部复发/残留肿瘤的危险因素。
超选择性动脉内顺铂灌注联合放疗方案如下：顺铂每周给药1次，共7周，每次给药剂量为100mg/m²。同期采用调强放射治疗进行放疗，总剂量为70Gy（2Gy/35次分割）。对2016年10月至2022年接受超选择性动脉内顺铂灌注联合放疗的31例晚期原发性上颌窦鳞状细胞癌患者，使用Cox风险模型回顾性分析局部复发/残留肿瘤的危险因素。分析的危险因素包括年龄、性别、T和N因素、翼状肌侵犯、影像学上的肿瘤异质性、扩散加权成像（b = 1000）上的肿瘤信号强度、扩散加权成像（b = 1000）上的肿瘤与脑干信号比值、第4次灌注后的治疗反应以及是否完成超选择性动脉内顺铂灌注联合放疗。我们还比较了复发/残留肿瘤组和未复发组之间的总生存期。
本研究纳入31例患者。在所有分析的危险因素中，未完成超选择性动脉内顺铂灌注联合放疗是唯一显示出统计学显著差异的危险因素。未复发/残留肿瘤组的总生存期较好；然而，与复发/残留肿瘤组相比无统计学差异。
完整的超选择性动脉内顺铂灌注联合放疗是预防局部复发/残留肿瘤的唯一因素。因此，所有参与超选择性动脉内顺铂灌注联合放疗的医疗人员应尽可能避免中断治疗。
