Daily concurrent chemoradiotherapy with docetaxel (D) and cisplatin (C) using new superselective intra-arterial infusion via the superficial temporal artery (HFT method) for stage III, IV head and neck cancer-Preservation of the primary lesion.
Daily concurrent chemoradiotherapy with docetaxel (D) and cisplatin (C) using new superselective intra-arterial infusion via the superficial temporal artery (HFT method) for stage III, IV head and neck cancer-Preservation of the primary lesion.
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对于 III、IV 期头颈癌，每日采用多西他赛 (D) 和顺铂 (C) 同步放化疗，通过颞浅动脉进行新的超选择性动脉内输注（HFT 方法），以保留原发灶。
DOI：
10.1200/jco.2006.24.18_suppl.15513
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Y. Ito
中科院分区：
文献类型：
--
作者：
I. Tohnai;N. Fuwa;K. Mitsudo;H. Nishiguchi;T. Fukui;N. Yamamoto;M. Ueda;Y. Ito
15513 背景：我们之前开发了一种通过颞浅动脉进行超选择性动脉内输注的新方法（HFT 方法；Hattori、Fuwa 和 Tohnai）。我们之前的研究涉及采用 HFT 方法对 41 名 III、IV 期口腔癌患者进行术前每日同步放疗和化疗，多西他赛 (D) 和顺铂 (C)。临床效果为完全缓解（CR）29例（82.9%），部分缓解（PR）6例（17.1%）；切除肿瘤病理效果为CR 31例（88.6%），PR 4例（11.4%），5年累积生存率（总生存率）为78.8%。因此，本研究调查了使用 HFT 方法无需手术的放化疗治疗 III、IV 期口腔癌的有效性。
方法
患有 III、IV 期口腔癌的患者 (n = 16) 接受了治疗。通过改造直径1.35毫米的血管造影导管，并使用导丝将其超选择性地经颞浅动脉插入肿瘤的供血动脉，制备了新的导管。通过这种方法可以进行长期导尿。每天同时进行放射治疗（总剂量：60 Gy）和使用D（总剂量：60 mg/m2）和C（总剂量：100 mg/m2）的超选择性动脉内灌注化疗。放化疗后行根治性颈清扫术，但原发病灶得以保留。
结果
3级以上的毒性包括白细胞减少症（6.3%）、粘膜炎（25.0%）和皮炎（18.8%）。没有感染与导管插入术相关。没有观察到重大并发症。 13例（81.5%）患者临床效果完全缓解，3例复发。对这3名患者进行了抢救手术。 3年累积生存率（总生存率）为87.5%，高于常规治疗。
结论
与 Seldinger 方法不同，我们的 HFT 方法允许长期插管，从而能够每天进行同步放化疗。该方法有望成为治疗 III、IV 期头颈癌的首选策略。没有需要披露的重大财务关系。
15513 Background: We previously developed a new method of superselective intra-arterial infusion via the superficial temporal artery (HFT method; Hattori, Fuwa and Tohnai). Our previous study involved preoperative daily concurrent radiotherapy and chemotherapy with docetaxel (D) and cisplatin (C) using the HFT method for 41 patients with stage III, IV oral cancer. Clinical effects were complete response (CR) in 29 (82.9%) and partial response (PR) in 6 (17.1%) patients and pathological effects of the resected tumor were CR in 31 (88.6%) and PR in 4 (11.4%) patients, with a 5-year cumulative survival rate (overall rate) of 78.8%. Thus, the present study investigated the effectiveness of chemoradiotherapy using the HFT method without surgery for stage III, IV oral cancer.
METHODS
Patients (n = 16) with stage III, IV oral cancer were treated. A new catheter was prepared by modifying a 1.35-mm diameter angiographic catheter and inserting it superselectively using a guide wire to the feeding artery of the tumor via the superficial temporal artery. Long-term catheterization is possible by this method. Radiotherapy (total dose: 60 Gy) and superselective intra-arterial infusion chemotherapy using D (total dose: 60 mg/m2) and C (total dose: 100 mg/m2) were concurrently performed daily. Radical neck dissection was performed after chemoradiotherapy, but the primary lesions were preserved.
RESULTS
Toxicities over grade 3 were leukopenia (6.3%), mucositis (25.0%), and dermatitis (18.8%). No infection was associated with catherization. No major complications were observed. The clinical effects were CR in 13 (81.5%) patients, with recurrences in 3 patients. Salvage operations were performed in these 3 patients. The 3-year cumulative survival rate (overall rate) of 87.5% is higher than that of conventional therapy.
CONCLUSIONS
Our HFT method, unlike the Seldinger method, allows for long-term catheterization, enabling daily concurrent chemoradiotherapy to be performed. This method promises to be the strategy of choice for the treatment of stage III, IV head and neck cancer. No significant financial relationships to disclose.