Stages III and IV squamous cell carcinoma of the mouth: Three-year experience with superselective intraarterial chemotherapy using cisplatin prior to definitive treatment

  • Toshinori Hirai
  • Yukunori Korogi
  • Satoshi Hamatake
  • Ryuichi Nishimura
  • Yuji Baba
  • Mutsumasa Takahashi
  • Yasuyoshi Uji
  • Akira Taen
Clinical Investigations

Abstract

Purpose: This study was designed to assess the 3-year experience with superselective intraarterial chemotherapy prior to definitive treatment for stages III and IV squamous cell carcinomas of the mouth.

Methods: Twenty-two patients prospectively received superselective intraarterial chemotherapy using relatively low-dose cisplatin via a transfemoral approach. The locations of the tumors were the tongue (n=12), gingiva (n=5), buccal mucosa (n=2), hard palate (n=1), floor of the mouth (n=1), and lip (n=1). After intraarterial chemotherapy, 21 patients underwent surgery (n=14), radiation therapy (n=6), or both (n=1). The survival rate of 25 patients who underwent surgery with/without radiationtherapy until 1992 at Kumamoto University Hospital was also evaluated as a historical control. The survival curve was calculated with the Kaplan-Meier method, and the statistical difference between survival curves was determined with the generalized Wilcoxon test.

Results: The overall response rate was 95% [complete response (tumor completely resolved), 24%; partial response (tumor reduction ≥50%), 71%]. Fifty-two intraarterial infusions were performed without any catheter-related complications. Mild and transient local toxicity such as edema or mucositis of the infused area was relatively common. One patient died of renal failure from cisplatin. After a median follow-up of 20 months (range 2–41 months), the estimated 3-year survival rate for patients who underwent intraarterial chemotherapy plus surgery was 91%. The survival of the patients who underwent intraarterial chemotherapy plus surgery tended to be longer than that of the historical control.

Conclusions: Early tumor reduction without delay of subsequent treatments can be obtained by intraarterial chemotherapy while minimizing complications and possibly improving survival. Further investigations of long-term survival with larger series need to be performed.

Key words

Head and neck neoplasm, therapy Chemotherapeutic infusion Intraarterial chemotherapy Oral cancer Squamous cell carcinoma 

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Copyright information

© Springer-Verlag 1999

Authors and Affiliations

  • Toshinori Hirai
    • 1
  • Yukunori Korogi
    • 1
  • Satoshi Hamatake
    • 1
  • Ryuichi Nishimura
    • 1
  • Yuji Baba
    • 1
  • Mutsumasa Takahashi
    • 1
  • Yasuyoshi Uji
    • 2
  • Akira Taen
    • 2
  1. 1.Department of RadiologyKumamoto University School of MedicineKumamotoJapan
  2. 2.Department of Oral and Maxillofacial SurgeryKumamoto University School of MedicineKumamotoJapan

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